On a biopsy you find sub-epithelial clefting with linear deposition of IgG and complement (C3) at the basement membrane zone (consistent with mucous membrane pemphigoid). Given the risk of ocular involvement, to which specialist should you refer?

Mucous membrane (cicatricial) pemphigoid can cause conjunctival scarring (symblepharon) and blindness; ophthalmology referral is essential to evaluate and protect the eyes.Other options: Cardiology, nephrology, and endocrinology are unrelated to the ocular complications of this disease.Key exam takeaway: Mucous membrane pemphigoid: refer to ophthalmology to prevent ocular scarring/blindness.