Mucous membrane pemphigoid, the rare systemic immune-mediated disease, can affect several mucous membranes, including the oral cavity, eye, nose, respiratory tract and gastrointestinal tract. Researchers from Liverpool recently determined that biopsies of the eye should be taken from peri-lesional sites in patients with the autoimmune disorder. The researchers found that tissue biopsied from this site was associated with an increase in positive direct immunofluorescence results.

The retrospective case series reviewed records of 32 patients with clinically suspected ocular mucous membrane pemphigoid. The researchers defined the location of the conjunctival samples as “lesional” when the sample was taken from a well-defined area of conjunctival scarring or symblepharon, “peri-lesional” when the sample was taken from an area of clinically uninvolved conjunctiva adjacent to a lesion and “non-affected,” when the sample was taken from a non-affected distant area, either from the forniceal conjuctiva or bulbar conjunctiva.

Direct immunofluorescence results were positive in 14% of lesional biopsies, 86% of peri-lesional and 17% of the non-affected group. Peri-lesional biopsies also provided more informative test results than lesional biopsies.

Coco G, Romano V, Menassa N, et al. Conjunctival biopsy site in mucous membrane pemphigoid. Am J Ophthalmol. February 15, 2020. [Epub ahead of print].