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Ocular pemphigus.

Yassine J Daoud1, Rene Cervantes, C Stephen Foster

  • 1Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA.

Journal of the American Academy of Dermatology
|October 4, 2005
PubMed
Summary
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Ocular involvement in pemphigus vulgaris (PV) is rare, affecting only the conjunctiva and eyelids without impacting vision. Patients typically achieve full recovery with systemic treatment, experiencing no lasting side effects.

Area of Science:

  • Ophthalmology
  • Dermatology
  • Autoimmune Diseases

Background:

  • Ocular involvement in pemphigus vulgaris (PV) is infrequently documented.
  • This study details ocular manifestations in 11 confirmed PV patients.

Purpose of the Study:

  • To describe the characteristics and outcomes of ocular involvement in patients with pemphigus vulgaris.
  • To assess the impact of PV on visual acuity and long-term prognosis.

Main Methods:

  • Retrospective analysis of medical records for 11 biopsy-proven PV patients (1990-2003).
  • Clinical data, including ocular findings, treatment, and follow-up, were reviewed.
  • Histopathological and immunofluorescence studies were performed on conjunctival and eyelid skin biopsies.

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Main Results:

  • Ocular involvement occurred in patients with pre-existing skin or mucosal lesions.
  • Affected sites included conjunctivae and eyelids; visual acuity remained unaffected.
  • Histology showed suprabasal acantholysis; direct immunofluorescence revealed IgG deposition.
  • Recurrence was noted in some patients, but all achieved full recovery without sequelae.
  • Ocular PV responded well to systemic therapy, with a mean remission of 32 months.

Conclusions:

  • Ocular involvement in PV is a rare condition.
  • Manifestations are confined to the conjunctiva and eyelids, without visual impairment.
  • Prompt treatment leads to complete recovery without long-term complications.