title: Corneal ulcer as an atypical presentation of ocular cicatricial pemphigoid.
abstract: OBJECTIVE
  To describe three patients, each presenting noninfective corneal epithelial damage as first manifestation of ocular cicatricial pemphigoid (OCP).
  
  
  METHODS
  Case report.
  
  
  RESULTS
  Patients 1 and 2 were referred to the authors' clinic for corneal ulcer while Patient 3 for relapsed epithelial defects. All patients had negative history for systemic diseases and microbiological tests were negative. Topical steroid treatment induced the complete resolution of corneal damage. During the follow-up period, the onset of mild conjunctival fibrosis in the lower fornix allowed the authors to suspect OCP, confirmed by conjunctival biopsy.
  
  
  CONCLUSIONS
  In the three patients corneal damage was an early sign of OCP, in the absence of typical signs of conjunctival fibrosis. The authors thus suggest considering conjunctival biopsy as a useful additional test in the management of idiopathic corneal ulcers.
authors.affiliation: Department of Ophthalmology, University of Roma, Campus Bio-Medico; G.B. Bietti Eye Foundation, IRCCS, Roma, Italy. s.bonini@unicampus.it
authors.forename: R
authors.initials: R
authors.lastname: Sgrulletta
authors.forename: A
authors.initials: A
authors.lastname: Lambiase
authors.forename: A
authors.initials: A
authors.lastname: Micera
authors.forename: S
authors.initials: S
authors.lastname: Bonini
mesh_terms: D000287:Administration, Topical; D000328:Adult; D003228:Conjunctiva / Q000473:pathology; D003320:Corneal Ulcer / Q000175:diagnosis* / Q000188:drug therapy; D019573:Epithelium, Corneal / Q000473:pathology; D005260:Female; D005355:Fibrosis; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D010390:Pemphigoid, Benign Mucous Membrane / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D005938:Glucocorticoids