Conjunctival erosions associated with pemphigus vulgaris.

PURPOSE: Pemphigus vulgaris (PV) is an autoimmune blistering disease that affects mucous membranes and the skin. Most commonly, the disease begins in the oral cavity and spreads to other areas including the conjunctiva and eyelids. Ocular involvement is rare and likely underdiagnosed with a frequency that is underestimated. Ocular manifestations of systemic PV can imply severe disease and require a multidisciplinary approach.

CASE REPORT: A 43-year-old black female presented with a chief complaint of pain with a white stringy discharge in the left eye for 2 weeks. On questioning, her health history revealed a 20-year systemic history of PV. Assessment of the anterior segment revealed diffuse conjunctival hyperemia with an area of bulbar conjunctival erosion. Based on the constellation of history, signs, and symptoms, ocular PV was diagnosed precipitating treatment for the ocular lesions and referral to the dermatologist for control of the underlying systemic condition.

CONCLUSIONS

PV is an autoimmune disease of the pemphigus classification. It is characterized by the production of autoantibodies that attack intercellular substances. We review this unusual entity, its immunopathology, and treatment.