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December 1988

Symmetrical Lid Margin Erosions: A Condition Specific to Pemphigus Vulgaris?

Author Affiliations

Sheffield, England

Arch Ophthalmol. 1988;106(12):1652-1653. doi:10.1001/archopht.1988.01060140824012

To the Editor.  —The vesicobullous diseases are variable in their ocular involvement. In contrast to mucous membrane pemphigoid, where ocular involvement is frequent and severe, pemphigus vulgaris (PV) is only rarely associated with ocular problems. We present a case of PV with ocular features, which we believe may represent a specific manifestation of the condition.

Report of a Case.  —A 53-year-old man presented in 1984 with a two-month history of oral ulceration and a rash on his chest and back. There were no other pertinent features in his medical history. Clinically, the lesions were those of PV, and skin biopsy specimens were obtained for histological examination and direct immunofluorescence (DIF).Histologic examination of the tissue showed acantholytic intraepidermal bulla formation near the basal layer with a dermal mixed inflammatory infiltrate and acutely inflamed fragments of superficial epidermis. Direct immunofluorescence showed intercellular epidermal staining for IgG. Serological examination showed a

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