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Bullous pemphigoid showing unusual ocular changes
1Department of Dermatology, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830, Japan.
The British Journal of Dermatology
|January 20, 1999
Summary
This study details a unique case of bullous pemphigoid presenting with distinct ocular lesions, characterized by corneal opacity and epithelial detachment, responding to corticosteroid treatment.
Area of Science:
- Dermatology
- Ophthalmology
- Immunology
Background:
- Bullous pemphigoid (BP) is an autoimmune blistering disease typically affecting the skin.
- Ocular involvement in BP is rare and often misdiagnosed.
Observation:
- A 68-year-old Japanese woman presented with erythematous and bullous skin lesions.
- Serum analysis revealed IgG class antibasement membrane zone antibodies targeting 230 kDa and 180 kDa bullous pemphigoid antigens.
- The patient developed bilateral corneal opacity and central epithelial detachment, distinct from cicatricial pemphigoid.
Findings:
- Ocular lesions were reproducible by injecting patient-derived IgG into rabbit corneas.
- Both skin and ocular manifestations showed a positive response to oral corticosteroid therapy.
- The findings suggest a unique ocular phenotype associated with bullous pemphigoid.
Implications:
- This case expands the understanding of bullous pemphigoid's potential ocular manifestations.
- Highlights the importance of considering BP in patients with unexplained ocular lesions.
- Suggests a potential autoimmune mechanism targeting ocular structures in specific BP cases.