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pseudopemphigoid as caused by topical drugs and pemphigus disease

World Journal of Ophthalmology 2015年第1期5卷 1-15页

作者： Laura C Huang James R Wong Javier Alonso-Llamazares Carlos H Nousari Victor L Perez Guillermo Amescua Carol L Karp Anat Galor Department of Ophthalmology Bascom Palmer Eye InstituteUniversity of Miami Miller School of MedicineMiamiFL 33136United States Department of Dermatology and Cutaneous Surgery Miami Veterans Administration Medical CenterMiamiFL 33136United States Institute for Immunofluorescence Pompano BeachFL 33069United States Ameripath/Quest South Florida Pompano BeachFL 33069United States Department of Dermatology and Cutaneous Surgery University of Miami Miller School of MedicineMiamiFL 33136United States Department of Ophthalmology Miami Veterans Administration Medical CenterMiamiFL 33136United States

pseudopemphigoid can cause a chronic cicatricial conjunctivitis that is clinically identical to the manifestations seen in mucous membrane pemphigoid, a disorder with a common clinical phenotype and multiple autoimmune links. For the purpose of this review, we will describe pseudopemphigoid as caused by topical drugs, the most common etiology with ocular manifestations, and as caused by the pemphigus disease, a more rare etiology. Specifically, we will discuss the ophthalmological features of drug-induced cicatricial conjunctivitis, pemphigus vulgaris, and paraneoplastic pemphigus. Other etiologies of pseudopemphigoid exist that will not be described in this review including autoimmune or inflammatory conditions such as lichen planus, sarcoidosis, granulomatosis with polyangiitis(Wegener's granulomatosis), erythema multiforme(minor, major, and Stevens-Johnson syndrome), bullous pemphigoid, skin-dominated linear IgA bullous dermatosis, and skin-dominated epidermolysis bullosa acquisita. Prompt diagnosis of the underlying etiology in pseudopemphigoid is paramount to the patient's outcome as certain diseases are associated with a more severe clinical course, increased ocular involvement, and differential response to treatment. A completehistory and ocular examination may find early cicatricial changes in the conjunctiva that are important to note and evaluate to avoid progression to more severe disease manifestations. When such cicatricial changes are noted, proper diagnostic techniques are needed to help elucidate a diagnosis. Lastly, collaboration between ophthalmologists and subspecialists such as dermatologists, pathologists, immunologists, and others involved in the care of the patient is needed to ensure optimal management of disease.

关键词： pseudopemphigoid Mucous membrane pemphigoid Cicatricial conjunctivitis Pemphigus vulgaris Paraneoplastic pemphigus Drug-induced conjunctival cicatrization

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