Skin diseases and the dry eye.

Patients with oral cicatricial pemphigoid, who present to an oral medicine department, should be examined by an ophthalmologist because over 65 per cent have been found to have an asymptomatic cicatrising conjunctivitis. Early detection and treatment of these patients may help to slow down the scarring process that eventually leads to a dry eye and blindness. The same is true for a group of patients who present to the dermatologist with a non-scarring bullous dermatosis distinguished by the presence of a linear deposit of IgA along the dermo-epidermal junction of uninvolved skin examined by direct immunofluorescence. The cicatrising conjunctivitis found in about 50 per cent of adults with this condition is indistinguishable from that of cicatricial pemphigoid. Ten per cent of patients with cicatricial pemphigoid affecting mucous membranes alone were found to have linear deposits of IgA along the dermo-epidermal junction of uninvolved skin. This suggested that there may be a common pathogenic pathway with varying clinical expression in these groups of patients and presents new possibilities for therapy in some patients with cicatricial pemphigoid.