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Technique of Conjunctival Biopsy and Direct Immunofluorescence for Diagnosing Mucous Membrane Pemphigoid
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Paraneoplastic conjunctival cicatrization: two different pathogenic types.

Audrey E Ahuero1, Frederick A Jakobiec, Pooja Bhat

  • 1Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts 02114, USA.

Ophthalmology
|January 5, 2010
PubMed
Summary
This summary is machine-generated.

Paraneoplastic conjunctival cicatrization, a rare condition, can manifest as ocular cicatricial pemphigoid or pemphigus. Early diagnosis via biopsy is crucial for identifying underlying malignancy in affected patients.

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Area of Science:

  • Ophthalmology
  • Dermatology
  • Oncology

Background:

  • Paraneoplastic conjunctival cicatrization is a rare condition associated with underlying malignancies.
  • It can present as either paraneoplastic ocular cicatricial pemphigoid (POCP) or paraneoplastic pemphigus (PNP) with ocular involvement.

Observation:

  • Two cases are presented: one with POCP and pulmonary squamous cell carcinoma, and another with PNP and B-cell chronic lymphocytic leukemia.
  • Clinical features included conjunctival scarring, symblephara, oral lesions, and skin rashes.

Findings:

  • Biopsies revealed characteristic immunopathologic findings: subepithelial bullae and immunoglobulin deposition in POCP, and subepidermal bullae with epidermal deposition in PNP.
  • Diagnostic studies confirmed POCP in the first patient and PNP in the second.

Implications:

  • Underlying malignancy should be suspected in younger patients with unexplained bilateral cicatrizing conjunctivitis.
  • Conjunctival or skin biopsies are valuable for diagnosing paraneoplastic conditions.