RESUMO
A 42-year-old man with ocular erythema and scarring had a conjunctival biopsy revealing depostion of IgM and C3 without IgG at the epithelial basement membrane zone. Treatment with doxycyline, dapsone, and mycophenolate mofetil was unsuccessful and treatment with rituximab has led to partial remission of the conjunctival inflammation. He has undergone 4 cycles of rituximab treatment at intervals of 12 to 18 months.
Assuntos
Anticorpos Anti-Idiotípicos/imunologia , Autoanticorpos/imunologia , Túnica Conjuntiva/patologia , Imunidade Inata , Imunoglobulina M/imunologia , Penfigoide Mucomembranoso Benigno/imunologia , Adulto , Biópsia , Técnica Direta de Fluorescência para Anticorpo/métodos , Seguimentos , Humanos , Fatores Imunológicos/uso terapêutico , Masculino , Penfigoide Mucomembranoso Benigno/diagnóstico , Penfigoide Mucomembranoso Benigno/tratamento farmacológico , Indução de Remissão , Rituximab/uso terapêuticoRESUMO
An otherwise healthy 43-year-old man presented with seven papules that had all erupted within the previous 6 months from an epidermal nevus on his left lower extremity. He reported that one of the new growths was painful and bled with minor trauma. Physical examination revealed a linear blaschkoid cobblestoned dark brown plaque that extended from the disto-lateral left thigh 30 cm to the mid-calf. Within the plaque inferior to the lateral popliteal fossa were six verrucous papules and a 4-mm round, pink, crusted, exophytic papule (Figure 1). A punch biopsy was taken from the plaque and saucerization shave biopsies of all the discrete papules.
