Core Messages

• Mucous membrane pemphigoid (MMP) is a group of chronic systemic autoimmune disorders characterized primarily by T-cell and B-cell dysfunction. Ocular cicatricial pemphigoid (OCP) is the MMP subset affecting the eye

• A key defect in the immune system response causes production of autoantibodies (IgG and IgA) directed against the b4-subunit of a6b4-integrin,and epiligrin (laminin type 5) in the conjunctival epithelium (hemidesmosome-epithelial membrane complex)

• HLA-DR2, HLA-DR4 [HLA-DR*0401], HLA-DQw7 [DQB1*0301], HLA A2, HLA-B*8, HLA-B*35 and HLA-B*49 genotypes may confer an increased genetic susceptibility to OCP

• A conformational change in the b4 peptide may lead to antigenic stimulation of certain B-cell clones that elaborate antibodies against the conjunctival basement membrane zone (BMZ) glycoproteins

• Proinflammatory cytokine mediated fibroblast activation leads to collagen production and subsequent cicatrization of the conjunctiva

• Conjunctival fibrosis produces an environment that leads to progressive corneal damage and loss of vision

• Extraocular manifestations of OCP must be sought in all patients to rule out potentially lethal systemic involvement (ex. esophagus or trachea)

• Staging using the Modified Foster Staging System early as a part of initial evaluation helps in management and prognosis

• Demonstration of linear deposition of immunoreactants [(IgG, IgA, IgM)

or complement (C3)] at the basement membrane zone (BMZ) of biopsied inflamed conjunctiva is necessary for definitive diagnosis

• An algorithmic approach of immunomodulation is recommended for treating the disorder

How To Deal With Rosacea and Eczema

How To Deal With Rosacea and Eczema

Rosacea and Eczema are two skin conditions that are fairly commonly found throughout the world. Each of them is characterized by different features, and can be both discomfiting as well as result in undesirable appearance features. In a nutshell, theyre problems that many would want to deal with.

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