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Updated: Aug 13, 2026

Technique of Conjunctival Biopsy and Direct Immunofluorescence for Diagnosing Mucous Membrane Pemphigoid
Published on: June 17, 2025
Eyelid skin involvement in pemphigus foliaceus
Yassine J Daoud1, C Stephen Foster, Razzaque Ahmed
1Massachusetts Eye and Ear Infirmary, Immunology and Uveitis Service, Harvard Medical School, Boston, MA, USA.
Purpose:
To report the involvement of eyelid skin in a patient with pemphigus foliaceus.
Methods:
Retrospective, interventional case report of a patient with pemphigus foliaceus involving both eyelids. The diagnosis of pemphigus foliaceus was based on histopathology and confirmed by direct immunofluorescence and immunoblot. Failure to respond to conventional immunosuppressive therapy, including high-dose corticosteroids, methotrexate, azathioprine, dapsone, and mycophenolate mofetil, necessitated the use of intravenous immunoglobulin (IVIg) therapy.
Results:
After successful treatment with IVIg, no change in visual acuity or other sequelae secondary to ocular pemphigus foliaceus were observed. Normal ocular architecture was maintained. Clinical remission was observed after successful therapy.
Conclusions:
Pemphigus foliaceus involves the skin of the eyelid and does not involve the conjunctiva. The patient did not respond to conventional immunosuppressive therapy. The use of IVIg as mono-therapy resulted in long-term clinical remission.
