Pemphigoid, cicatricial

Shore, J.W., Foster, C.S., WestfaU, C.T., Rubin, P.A. Results of buccal mucosal grafting for patients with medically controlled ocular cicatricial pemphigoid. Ophthalmology 99, 383-395 (1992)... 

Figure 25-27 Conjunctival shrinkage and symblepharon formation (arrows ) in ocular cicatricial pemphigoid.

Figure 25-28 Keratinization of conjunctiva and cornea in ocular cicatricial pemphigoid.

Donnemeld ED, Perry HD, WaUerstein A. Subconjunctival mitomycin C for the treatment of ocular cicatricial pemphigoid. Ophthalmology 1999 106 72-78. 

Nguyen QD, Foster CS. Cicatricial pemphigoid diagnosis and treatment, hit Ophthalmol CUn 1996 36 41-60. 

Influenza vaccine is one of at least 30 drugs beheved to cause bullous pemphigoid or cicatricial pemphigoid (42). 

Cheilosis has also been reported (178). Oral lesions in patients using penicillamine may be due to pemphigus, cicatricial pemphigoid, or lichen planus, even in the absence of lesions outside the oral cavity. In 56 consecutive patients taking penicillamine, oral lichen planus was found in as many as seven (179). Penicillamine-induced cicatricial pemphigoid can be associated with oral ulcers as well as lesions of the esophagus, and stenosis can develop. 

A rare but potentially serious skin reaction to penicillamine is cicatricial pemphigoid (312,313). These patients can have symblepharon and entropion of the eyes, ulcers in the mouth, and blistering lesions on the trunk, extremities, and perineum (314). Involvement of the esophageal or vaginal epithelium can cause stenosis. 

Ulcerative lesions of the vagina can occur in patients taking penicillamine, as a manifestation of pemphigus or cicatricial pemphigoid, or following impaired collagen synthesis (SED-8, 533) (315). 

Shuttleworth D, Graham-Brown RA, Hutchinson PE, Jolliffe DS. Cicatricial pemphigoid in D-penicillamine treated patients with rheumatoid arthritis—a report of three cases. Clin Exp Dermatol 1985 10(4) 392-7. 

Peyri J, Servitje O, Ribera M, Henkes J, Ferrandiz C. Cicatricial pemphigoid in a patient with rheumatoid arthritis treated with D-penicillamine. J Am Acad Dermatol 1986 14(4) 681. 

Marti-Huguet T, Quintana M, Cabiro I. Cicatricial pemphigoid associated with D-penicillamine treatment. Arch Ophthalmol 1989 107(8) 1115. 

The risk of thrombosis from thalidomide may be increased in certain conditions, such as malignancies, cicatricial pemphigoid (29), and systemic lupus erythematosus. Four episodes of thrombosis (two arterial, two venous) occurred in three patients with systemic lupus erythematosus and one with severe atopic dermatitis within 10 weeks of starting treatment with thahdomide 50-100 mg/day (30). All four had at least one risk factor for thrombosis, but none had thrombosis before or after treatment with thahdomide. 

Howell E, Johnson SM. Venous thrombosis occurring after initiation of thalidomide for the treatment of cicatricial pemphigoid. J Drugs Dermatol 2004 3(l) 83-5. 

Austin AS +, EurJ Gastroenterol Hepatol 13, 193 (1992) Taylor AE +, Acta Derm Venereol 72(2), I 15 Cicatricial pemphigoid... 

---