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Direct immunofluorescence investigation in patients with clinical suspicion of ocular cicatricial pemphigoid

PURPOSE: To report the findings in patients with clinical suspicion of ocular cicatricial pemphigoid (OCP) and to present the results of direct immunofluorescence investigation. METHODS: Prospective study performed at the Federal University of São Paulo. Clinical examination and conjunctival biopsies were performed in thirteen patients (26 eyes) who presented clinical evidence of OCP without systemic immunosuppression therapy or topic anti-glaucoma drug use. Immunofluorescence was immediately performed after obtaining biopsies. RESULTS: According to Foster's staging system, the proportions of eyes classified as stage I to IV were 3.8%, 3.8%, 77% and 15.4%, respectively. Only three (3) of thirteen (13) patients (23%) were positive on performing immunofluorescence technique. CONCLUSION: This study shows that the diagnoses of ocular cicatricial pemphigoid were established at advanced stages of the disease and that direct immunofluorescence presented low sensitivity in detecting immunoreactant deposition along the basement membrane of the conjunctiva, when compared to the literature.

Benign mucousmembrane pemphigoid; Vesiculobullous skin diseases; Basement membrane; Conjunctiva; Direct fluorescent antibody technique


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