Ocular manifestation of bullous and cicatricial pemphigoid

Purpose: Pemphigoid is classified into 2 types, bullous pemphigoid (BP) and cicatricial pemphigoid (CP), depending on the target antigen. We investigated ocular manifestations for each type of pemphigoid. Methods: Clinical records of definitive pemphigoid cases diagnosed by the Department of Dermatology, Keio University Hospital were retrospectively reviewed. Results: Ninety-five cases (BP, 83 cases: CP, 12 cases) were recruited. In 23 (27.7%) of the BP cases and 11 (91.7%) of the CP cases, ophthalmological examination was performed. In 18 cases of the 23 BP cases, various ocular diseases (cataract, 10 cases: keratoconjunctivitis, 8 cases: glaucoma, 4 cases: miscellaneous, 6 cases; allowing double-counting) were found, but no case was associated with ocular cicatricial pemphigoid (OCP). In contrast, OCP of various stages (stage 2, 1 eye: stage 3, 10 eyes, stage 4, 5 eyes; Foster's grading) was found in 8 of the 11 CP cases. Conclusions: CP but not BP is frequently associated with OCP. Most of ocular complications in BP are presumed to be due to corticosteroid medication.