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Case Report



Ocular cicatricial pemphigoid: A difficult treatment case

Diana Marcela Espitia-Hernandez, Daniela Chaparro-Reyes, Adriana Patricia Cruz-Garnica, Karen Villa-Mendez, Carolina Cortes-Correa, Elkin Peñaranda-Contreras.




Abstract
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Background: Mucous membrane pemphigoid (MMP) or cicatricial pemphigoid is an autoimmune disease associated with high morbidity. It presents as erosive mucosal lesions with scarring for which different treatments are used, depending on the degree of involvement. It may cause ocular complications requiring interdisciplinary management together with ophthalmology specialists because patients may need cataract surgery and corneal transplant in the event of perforation, or even a keratoprosthesis as the only option for visual rehabilitation.
Case Presentation: Clinical case of the dermatology service of University Hospital La Samaritana in Bogota, Colombia. The patient presented with multiple illnesses and a longstanding history of the disease with no improvement despite multiple approaches to management. In view of disease activity after several treatments and because of the need for surgery, annual rituximab administration was instituted in an attempt at controlling the disease and avoiding reactivations.
Conclusion: MMP is a disease associated with high morbidity. Diagnosis is usually delayed because onset of the disease is not evident at first and because of similarity with other diseases, resulting in the use of inadequate treatments in the absence of high quality evidence about potential interventions. In some cases, treatment for life is required in order to prevent progression.

Key words: Mucous membrane pemphigoid, cicatricial pemphigoid, Ocular pemphigoid






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