Immunologic aspects of cicatricial pemphigoid

A 56-year-old woman presented with the typical findings of cicatricial pemphigoid: vesicular lesions of the mucous membranes and skin. Ocular involvement included symblepharon and dryness. A regimen of 80 mg of oral trimcinolone per day healed the lesions of the skin and mucous membrane. The patient received three injections of 0.5 ml of triamcinolone acetonide into the area of the symblepharon without apparent effect on the ocular disease. Direct immunofluorescent microscopy of the patient's conjunctiva revealed fluorescence of the basement membrane when incubated with fluorescein labeled anti-IgG. The finding of immunologlobulin fixed to be basement membrane in cicatricial pepmhigoid indicates some type of immune mechanism, and would seem to place this entity in the spectrum of the pemphigus-pemphigoid group.