Cicatricial pemphigoid

Cicatricial pemphigoid (Fig. 9.8)

Like pemphigoid itself, cicatricial pemphigoid is an autoimmune skin disease showing IgG and C3 depo-sition at the basement membrane zone (Fig. 9.5). The antigens are often as in pemphigoid, but other anti-gens are sometimes targeted such as laminin 5 (in anchoring filaments). The condition differs from pem-phigoid in that its blisters and ulcers occur mainly on mucous membranes such as the conjunctivae, the mouth and genital tract. Bullae on the skin itself are uncommon. Lesions heal with scarring: around the eyes this may cause blindness, especially when the palpebral conjunctivae are affected (Fig. 9.8). The condition tends to persist and treatment is relatively ineffective, although very potent local steroids, sys-temic steroids and immunosuppressive agents are usually tried. Good eye hygiene and the removal of ingrowing eyelashes are important.