Date post: | 22-Jan-2018 |
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1. Cicatricial pemphigoid
2. Stevens-Johnson syndrome
3. Toxic epidermal necrolysis (Lyell disease)
4. Epidermolysis bullosa
5. Pemphigus vulgaris
6. Linear IgA bullous dermatosis
IMMUNOBULLOUS DISEASES
Cicatricial pemphigoid• Chronic and progressive• Typically affects elderly women• Increased prevalence of HLA-B12
Oral mucosal lesions in most cases Skin lesions are less common
Progression of ocular cicatricial pemphigoid
Diffuse hyperaemia
Subepithelial fibrosis and shrinkage Symblepharon
Pseudomembrane formation
Complications of ocular cicatricial pemphigoid
Ankyloblepharon
Corneal keratinization
Metaplastic lashes Cicatricial entropion
Total obliteration of fornices Secondary bacterial keratitis
Stevens-Johnson syndrome• Acute, and self-limiting• Hypersensitivity to drugs or infection• Typically affects young men
Lesions of oral mucosa and lips
Maculopapules which may develop into target lesions
Vesciculobullous haemorrhagicand necrotic lesions
Ocular complications of Stevens-Johnson syndrome
Transient conjunctivitis and lid crusting without sequelae
Severe membranous or pseudomembranous conjunctivitis
Focal fibrotic patches andoccasionally symblepharon
Metaplastic lashes
Other immunobullous diseases (1)Toxic epidermal necrolysis
(Lyell disease)
• ‘Scalded’ skin lesions
• Conjunctivitis - common and similar to Stevens-Johnson syndrome
Epidermolysis bullosa
• Skin bullae and necrosis induced by minor trauma• Conjunctivitis - common and may result in scarring
Pemphigus vulgaris
• Flaccid, weeping bullae
• Conjunctivitis - uncommon and mild
Linear IgA bullous dermatosis
• Tense bullae of varying size
• Conjunctivitis - common and may result in scarring
Other immunobullous diseases (2)