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Revista Colombiana de Reumatología
versão impressa ISSN 0121-8123
Resumo
RINGER, Ariana et al. Ocular cicatricial pemphigoid. From a rheumatology and ophthalmology point of view. Rev.Colomb.Reumatol. [online]. 2022, vol.29, n.1, pp.57-67. Epub 14-Jan-2023. ISSN 0121-8123. https://doi.org/10.1016/j.rcreu.2020.12.006.
Ocular cicatricial pemphigoid (OCP) is a chronic, immune-mediated, bullous, cicatricial disease within the spectrum of mucocutaneous membranous pemphigoids (MMP). Although the diagnosis is often ophthalmological, due to the autoimmune nature of the pathology, it requires a joint approach with rheumatologists and immunologists. The objective of this narrative review was to explore the evidence available in the literature from 2000 to 2020 with respect to clinical manifestations, diagnosis, and treatment. The clinical presentation varies widely, from mild cases with slow progression of years of progression, to severe cases with a torpid and rapidly progressive evolution to fibrosis, refractory to multiple treatments. A com plete evaluation of the patient will help guide the diagnosis. The gold standard for diagnosis is conjunctival biopsy with direct immunofluorescence, although on occasions it can be reached if the symptoms are characteristic. Treatment is local and systemic according to its severity and evolution. The evidence on topical and systemic therapeutics is obtained mainly from uncontrolled observational and experimental studies. Immunomodulatory therapy has made it possible to preserve vision and, in many cases, prevent sequelae. The evolu tion is linked to the early diagnosis and immunosuppressive treatment, so it is essential to be aware of this disease, the diagnostic methods, as well as the immunomodulating and immunosuppressive therapies available.
Palavras-chave : Pemphigoid; Benign mucous membrane; Ocular cicatricial pemphigoid; Benign mucosal pemphigoid; Dry eye syndromes; Conjunctivitis; Diagnostic techniques ophthalmological; Therapeutics; Immunosuppressive agents immunomodulation.