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Technique of Conjunctival Biopsy and Direct Immunofluorescence for Diagnosing Mucous Membrane Pemphigoid
Published on: June 17, 2025
Childhood Mucous Membrane Pemphigoid: A Case With Exclusively Ocular Involvement
Andréane Lavallée1, Dominique Bourret-Massicotte, Patricia Ann Laughrea
1Centre Universitaire d'Ophtalmologie, Hôpital du Saint-Sacrement, CHU de Québec, Québec, Canada.
Cornea
|August 27, 2013
Summary
Childhood mucous membrane pemphigoid (MMP) is rare, especially with only eye symptoms. A delayed second biopsy confirmed MMP in a pediatric patient, highlighting the need for repeat testing in suspected cases.
Area of Science:
- Ophthalmology
- Dermatology
- Pediatrics
Background:
- Mucous membrane pemphigoid (MMP) is a rare autoimmune blistering disease.
- Pediatric cases of MMP are exceptionally uncommon, particularly those presenting solely with ocular manifestations.
Observation:
- A 12-year-old girl presented with symptoms of conjunctival cicatrization, symblepharon, and peripheral keratitis.
- Initial conjunctival biopsy and immunofluorescence were negative for MMP.
- Symptoms recurred over 30 months, prompting a second biopsy.
Findings:
- The second conjunctival biopsy confirmed the diagnosis of mucous membrane pemphigoid via positive direct immunofluorescence.
- Systemic workup for autoimmune vasculitis was negative.
- Treatment with dapsone resulted in a favorable clinical response.
Implications:
- This case underscores the rarity of childhood MMP with exclusive ocular involvement.
- It emphasizes the importance of considering MMP in the differential diagnosis of chronic pediatric conjunctival inflammation and fibrosis.
- A negative initial biopsy should not preclude diagnosis; repeat biopsies are valuable in clinically suspected cases.
