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Consensus Statement
March 2002

The First International Consensus on Mucous Membrane PemphigoidDefinition, Diagnostic Criteria, Pathogenic Factors, Medical Treatment, and Prognostic Indicators

Author Affiliations

From the Department of Dermatology, Northwestern University Medical School, Chicago, Ill (Drs Chan and West); Department of Oral Medicine and Diagnostic Sciences, Harvard School of Dental Medicine, Boston, Mass (Dr Ahmed); Department of Dermatology, Johns Hopkins Medical Institute, Baltimore, Md (Dr Anhalt); Department of Ophthalmology, University of Zurich, Zurich, Switzerland (Dr Bernauer); Department of Dermatology, Case Western Reserve University School of Medicine, Cleveland, Ohio (Drs Cooper and Korman); Department of Ophthalmology, Christchurch Hospital, Christchurch, New Zealand (Dr Elder); Department of Dermatology, University of North Carolina, Chapel Hill (Dr Fine); Department of Ophthalmology, Massachusetts Eye and Ear Infirmary and Harvard Medical School, Boston (Dr Foster); Department of Dermatology, Thomas Jefferson Medical College, Philadelphia, Pa (Dr Ghohestani); Department of Dermatology, Kurume University School of Medicine, Fukuoka, Japan (Dr Hashimoto); Department of Ophthalmology, Hôpital Bichat, Paris, France (Dr Hoang-Xuan); Department of Dermatology, Urije University, Amsterdam, the Netherlands (Dr Kirtschig); Moorfields Eye Hospital and Institute of Ophthalmology, University College London, London, England (Dr Lightman); Department of Stomatology, School of Dentistry, University of California, San Francisco (Dr Lozada-Nur); Department of Dermatology, Stanford University School of Medicine, Stanford, Calif, and Veterans Affairs Health Care System, Palo Alto, Calif (Dr Marinkovich); Jules Stein Eye Institute and Department of Ophthalmology, University of California, Los Angeles (Dr Mondino); Department of Dermatology and Policliniqe de Dermatologie, Hôpital Saint-Louis, Paris, France (Dr Prost-Squarcioni); Department of Dermatology, Mayo Clinic, Rochester, Minn (Dr Rogers); St John's Institute of Dermatology, St Thomas' Hospital, London, England (Dr Setterfield); Department of Dermatology, Churchill Hospital, Oxford, England (Dr Wojnarowska); Division of Dermatology, University of Southern California, Los Angeles (Dr Woodley); Dermatology Branch, Division of Clinical Sciences, National Cancer Institute, National Institutes of Health, Bethesda, Md (Dr Yancey); Department of Dermatology, University of Wurzburg, Wurzburg, Germany (Dr Zillikens); and Department of Dermatology, University of Utah, Salt Lake City (Dr Zone).

Arch Dermatol. 2002;138(3):370-379. doi:10.1001/archderm.138.3.370
Abstract

Objective  We aimed to develop consensus-based recommendations for streamlining medical communication among various health care professionals, to improve accuracy of diagnosis and treatment, and to facilitate future investigations for mucous membrane pemphigoid.

Participants  Because of the highly specific nature of this group of diseases, the 26 invited participants included either international scholars in the field of mucous membrane pemphigoid or experts in cutaneous pharmacology representing the 3 medical disciplines ophthalmology, oral medicine, and dermatology.

Evidence  The first author (L.S.C.) conducted a literature search. Based on the information obtained, international experts who had contributed to the literature in the clinical care, diagnosis, and laboratory investigation for mucous membrane pemphigoid were invited to participate in a consensus meeting aimed at developing a consensus statement.

Consensus Process  A consensus meeting was convened and conducted on May 10, 1999, in Chicago, Ill, to discuss the relevant issues. The first author drafted the statement based on the consensus developed at the meeting and the participants' written comments. The draft was submitted to all participants for 3 separate rounds of review, and disagreements were reconciled based on literature evidence. The third and final statement incorporated all relevant evidence obtained in the literature search and the consensus developed by the participants. The final statement was approved and endorsed by all 26 participants.

Conclusions  Specific consensus-based recommendations were made regarding the definition, diagnostic criteria, pathogenic factors, medical treatment, and prognostic indicators for mucous membrane pemphigoid. A system of standard reporting for these patients was proposed to facilitate a uniform data collection.

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