Mucous membrane pemphigoid (MMP) is an autoimmune blistering disease characterized by erosive
mucosal lesions mainly on the oral and ocular mucosae (1). We report a case of oral and ocular anti-BP180-
type MMP with variable IgG and IgA reactivities and
underlying dementia.
An 84-year-old Japanese man presented with a
4-year history of erosions in the oral cavity and on the
conjunctivae, with progressive vision impairment.
The medical history included benign prostatic hyperplasia, cataract, sinusitis, and dementia. Physical examination revealed erosions and white atrophic scars
along the gingival mucosa and on the hard palate
(Figure 1, a, b). Conjunctival inflammation and corneal scarring were also observed only on the left eye
(Figure 1, c, d). No lesions were observed on the skin
or on any other mucosae.
A skin biopsy from the patient’s oral mucosa
showed lymphocytic infiltration in the superficial
dermis without apparent subepithelial blister. Direct
immunofluorescence showed linear depositions of
IgG, IgA, and C3 at the epithelial basement membrane zone (Figure 1, e-g)
