Eyelid skin involvement in pemphigus foliaceus.
OBJECTIVE
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.
Daoud
Yassine J
YJ
Massachusetts Eye and Ear Infirmary, Immunology and Uveitis Service, Harvard Medical School, Boston, MA, USA.
Foster
C Stephen
CS
Ahmed
Razzaque
R
D000328:Adult; D000888:Antibodies, Anti-Idiotypic / Q000276:immunology; D001706:Biopsy; D051183:Desmoglein 1 / Q000276:immunology; D051184:Desmoglein 3 / Q000276:immunology; D003937:Diagnosis, Differential; D005141:Eyelid Diseases / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D005143:Eyelids / Q000473:pathology*; D019085:Fluorescent Antibody Technique, Direct; D005500:Follow-Up Studies; D006801:Humans; D015151:Immunoblotting; D007074:Immunoglobulin G / Q000276:immunology; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007155:Immunologic Factors / Q000627:therapeutic use; D008297:Male; D018613:Microscopy, Confocal; D010392:Pemphigus / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D012189:Retrospective Studies
D000888:Antibodies, Anti-Idiotypic; D051183:Desmoglein 1; D051184:Desmoglein 3; D007074:Immunoglobulin G; D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors