Ocular Cicatricial Pemphigoid, Keratomycosis, and Intravenous Immunoglobulin Therapy

Abstract

Patients with uncontrolled OCP are at increased risk of corneal infection. The difficulty in diagnosing keratomycosis and the relatively rare occurrence of OCP explain the uniqueness of our reported case. OCP may progress to "end-stage" disease despite therapy. Keratoprosthesis can restore vision in selected otherwise seemingly hopeless cases.

Ocular involvement in oral vesiculobullous diseases: A review on reported cases in the literature

“… Azathioprine and steroid-sparing therapy. N/A Iaccheri et al, 2004 1 39 M MMP Oral mucosa N/A N/A Bilateral Photophobia, thickened eyelid, conjunctival injection, foreshortening of fornices, symblephara, conjunctivitis, trichiasis, and keratopathy No N/A Topical antibiotic, amphotericin B drop, cyclophosphamide, subcutaneous cytosine arabinoside, IVIg therapy, and prednisone Seth et al, 2004 1 64 M MMP Palate, tongue, throat Blisters N/A Bilateral Conjunctival ulceration and symblepharon formation No Oral steroids on a tapering dose IV cyclophosphamide Lifshitz et al, 2004 1 20 M Pemphigus vulgaris Buccal mucosa, palate, pharynx, and larynx Erosions and blisters N/A Bilateral Conjunctival hyperemia, diffuse induration and thickening of eyelids, lid margin erosions in upper and lower lids No Oral prednisone, triamcinolone, and azathioprine Dexamethasone and chloramphenicol drops, antiglaucomatous drops, fusidic acid ointment, and artificial tears Canizares et al, 2006 5 52 F: 5 MMP Gingiva, hard palate, and tongue Erosion 48 months Bilateral Dry eye syndrome, symblephara, conjunctival and corneal ulceration, subepithelial erythema, fibrosis, keratopathy, and nuclear sclerosis No Dapsone, azathioprine sodium, clobetasol propionate ointment, nystatin, prednisone, etanercept, dexamethasone elixir, and topical fluocinonide gel IVIg, prednisone, dapsone, clobetasol propionate, nystatin, hydrochlorothiazide, cyclophosphamide, valacyclovir hydrochloride, acyclovir, cyclosporine, and mycophenolate mofetil Palleschi et al, 2007 3 53 M: 1 F: 2 Pemphigus vulgaris Palate Erosion 2 months, synchronous ...…”

Localized Oral Mucous Membrane Pemphigoid: Successful Treatment with Intralesional Triamcinolone Acetonide Injection

“…Also Letko et al [21] stated IVIg therapy induced faster control of the acute inflammation by comparison with conventional immunosuppressive therapy in patients with MMP and no recurrences were recorded in IVIg therapy during the follow-up period. However, Iaccheri et al reported IVIg with systemic steroids and immunosuppressive agents failed to control ocular MMP [22] . A tetracycline type antibiotic, minocycline, alone or in combined with nicotinamide has also been reported in the treatment of MMP [23,24] .…”