**8. Conclusions**

PUK is a destructive inflammatory disease of the juxtalimbal cornea. This may occur in the course of an autoimmune disease that has already been diagnosed or may be its first manifestation, with serious systemic consequences. The underlying pathogenesis is not fully understood but appears to involve both cell-mediated as well as auto-antibody-mediated components, resulting in the breakdown of peripheral corneal tissue. PUK is potentially devastating and vision-threatening condition that may lead to corneal melting and perforation. However, surgical procedures performed in the management of PUK associated with collagen vascular disease or vasculitis involve various complications and a high incidence of failure.

When dealing with PUK of autoimmune etiology, the collaboration of an ophthalmologist and an internist/rheumatologist is crucial. It is important to control inflammation of the involved ocular tissues, but especially systemic inflammation, through prompt and optimal management including systemic corticosteroids and tailored immunomodulatory drugs. A great glimpse into the future of PUK management is provided by evolving biological therapies with promising results.
