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Manfred Zierhut, Deshka Doycheva, Christoph M E Deuter, Bianka Sobolewska, Martin Schaller; Ocular Cicatricial Pemphigoid induced by Adalimumab. Invest. Ophthalmol. Vis. Sci. 2017;58(8):4371.
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© ARVO (1962-2015); The Authors (2016-present)
Ocular cicatricial pemphigoid (OC) represents the most typical chronic bullous cicatricial conjunctivitis. Often based on an autoimmune mechanism also drugs are known to induce OCP. In the following we present the first case of OCP induced by adalimumab, a TNF-alpha blocking biologic.
We analyzed a patient who had been treated for his psoriasis with adalimumab, developing symblepharon formation and severe keratitis. Besides clinical analysis we used immunofluorescence and histology for the correct differential diagnosis.
We present a 47 year old patient with an overlap syndrome of rosacea and psoriasis. He waqs under treatment with the anti-TNF-alpha agent adalimumab since app. 2 yyears. When he developed massive symblepharon formation with keratitis and entropium formation, the conjunctival biopsy using immunohistology had shown a linear IgG formation of the basal membrane zone of the conjunctiva, a typical finding for OCP. His treatment with adalimumab was stopped and he used Myfortic (2x720 mg). During the next 3 months he showed clear improvement, leading to a quiet uninflamed eye.
Various drugs have been reported to induce OCP. This is the first report about a biologic agent. Until now only 6 patients have been published, all developing bullous skin disease without ocular involvement, like bullous pemphigoid, pemphigus vulgaris, and linear IgA-dermatosis.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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