A 76-year-old male patient presented with pain, tearing and secretion in the left eye (LE) associated with severe red eye of 1 month onset.
One month before, the ENT service had been clinically diagnosed with a supposed mucosal Pemphigus Vulgar in the throat and mouth pending biopsy, for which she was being treated with Prednisone 30 mg daily.
The patient had a history of hypercholesterolemia treated with torvastatin.
Pathological examination showed visual acuity (VA) of 1.2 in right eye (OD) and 1.0 in left eye.
A large blister was found in the bulbar conjunctiva sector, associated with hyperemia, nasal erosion in 24 hours; the rest of the examination was normal in both eyes.
Then it was decided to perform a conjunctival biopsy in the consultation under topical anesthesia in the lesion area.
Treatment with gentamicin ointment and fluoroquinone eye drops was initiated every 8 hours.
Histopathology showed supraepithelial bulla while direct FI showed deposits of immunoglobulin G (IgG) in the intercellular spaces of the conjunctival epithelium.
When establishing the diagnosis of Pemphigus Vulgar, the dose of Prednisone was increased to 60 mg/day, achieving remission of ocular symptoms at two months.
