June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Ocular Cicatricial Pemphigoid induced by Adalimumab
Author Affiliations & Notes
  • Manfred Zierhut
    Centre for Ophthalmology, University of Tuebingen, Tuebingen, Germany
  • Deshka Doycheva
    Centre for Ophthalmology, University of Tuebingen, Tuebingen, Germany
  • Christoph M E Deuter
    Centre for Ophthalmology, University of Tuebingen, Tuebingen, Germany
  • Bianka Sobolewska
    Centre for Ophthalmology, University of Tuebingen, Tuebingen, Germany
  • Martin Schaller
    Dep. of Dermatology, University of Tuebingen, Tuebingen, Baden-Wuerttemberg, Germany
  • Footnotes
    Commercial Relationships   Manfred Zierhut, AbbVie (F); Deshka Doycheva, None; Christoph Deuter, AbbVie (F); Bianka Sobolewska, None; Martin Schaller, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 4371. doi:
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    • Get Citation

      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)

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Purpose : 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.

Methods : 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.

Results : 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.

Conclusions : 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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