Pathology · patient case question
Which pathology produces conjunctival damage?
Patient case: Pemphigus vulgaris and mucous membrane pemphigoid
Scenario: Questions on the vesiculobullous diseases.
Show answer and explanation
Correct answer: C. Mucous membrane pemphigoid
- A. Lichen planus can rarely involve other sites but does not cause the progressive cicatrising conjunctivitis of MMP.
- B. Pemphigus vulgaris involves skin and mucous membranes but does not characteristically scar the conjunctiva.
- C. Correct. Mucous membrane (cicatricial) pemphigoid has a strong predilection for OCULAR involvement. Subconjunctival scarring produces SYMBLEPHARON (adhesion of the conjunctiva to the globe), entropion, trichiasis, corneal damage and ultimately BLINDNESS. This is why any suspected case is referred urgently to an OPHTHALMOLOGIST.
- D. Aphthous ulceration is confined to non-keratinised oral mucosa. (Behçet syndrome — a distinct condition — does cause uveitis with oral and genital ulceration.)
Note: The word CICATRICIAL means scarring — that is the whole point of the referral. Ophthalmology referral is mandatory even when the eyes appear normal at diagnosis.