1. Cicatricial pemphigoid

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IMMUNOBULLOUS DISEASES
1. Cicatricial pemphigoid
2. Stevens-Johnson syndrome
3. Toxic epidermal necrolysis (Lyell disease)
4. Epidermolysis bullosa
5. Pemphigus vulgaris
6. Linear IgA bullous dermatosis
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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
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Progression of ocular cicatricial pemphigoid
Diffuse hyperaemia
Pseudomembrane formation
Symblepharon
Subepithelial fibrosis and shrinkage
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Complications of ocular cicatricial pemphigoid
Ankyloblepharon
Cicatricial entropion
Metaplastic lashes
Corneal keratinization
Total obliteration of fornices
Secondary bacterial keratitis
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Stevens-Johnson syndrome

• Acute, and self-limiting

• Hypersensitivity to drugs or infection

• Typically affects young men

Lesions of oral mucosa and lips
Vesciculobullous haemorrhagic and necrotic lesions
Maculopapules which may develop into target
lesions
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Ocular complications of Stevens-Johnson syndrome
Transient conjunctivitis and lid crusting
without sequelae
Severe membranous or pseudomembranous
conjunctivitis
Focal fibrotic patches and occasionally
symblepharon
Metaplastic lashes
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Other immunobullous diseases (1)
Toxic epidermal necrolysis (Lyell disease)
Epidermolysis bullosa

• Skin bullae and necrosis induced by
• minor trauma

• Scalded skin lesions

• Conjunctivitis - common and similar to
• Stevens-Johnson syndrome

• Conjunctivitis - common and may result
• in scarring

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Other immunobullous diseases (2)
Pemphigus vulgaris
Linear IgA bullous dermatosis

• Tense bullae of varying size

• Flaccid, weeping bullae

• Conjunctivitis - common and may result
• in scarring

• Conjunctivitis - uncommon and mild