Corneal perforation as a complication of epidermolysis bullosa acquisita

Epidermolysis bullosa acquisita (EBA) is now recognised as a histopathologically distinct condition. Ocular complications of hereditary epidermolysis bullosa (EB) have been well documented, but little has been reported with respect to the ocular manifestations associated with the acquired form. A patient with EBA and sarcoidosis--an association that does not appear to have been previously reported--developed spontaneous peripheral corneal melting and perforation. The defect healed with the use of a bandage contact lens, antibiotics, mydriatics and pulsed intravenous steroids, and resulted in a satisfactory visual outcome.