A case of antilaminin 332 mucous membrane pemphigoid showing a blister on the bulbar conjunctiva and a unique epitope on the α3 subunit

Conflicts of interest: none declared. Madam, A 57‐year‐old Japanese woman developed severe erosive lesions on the oral mucosae including buccal mucosae, gingivae, hard palate and soft palate, as well as bleeding and crust formation on the nasal mucosae in August 2007. She also showed bloody blisters and crusted erosions 2–4 cm in size scattered on the trunk and extremities. Oral minocycline 200 mg daily was given. However, the erosive lesions on the oral and nasal mucosae continued to develop and a clear blister 5 × 8 mm in size appeared on the left bulbar conjunctiva (Fig. 1). Therefore, minocycline was replaced by oral prednisolone 40 mg daily, but the mucosal and skin lesions still continued. Then, a combination therapy of oral prednisolone 40 mg daily and dapsone 75 mg daily was initiated. The oral and nasal mucosal lesions healed without any scarring. The blister on the bulbar conjunctiva disappeared without any scarring or sight disturbance. The skin lesions also healed leaving slight scarring. Then, the dose of prednisolone was tapered gradually without lowering the dose of dapsone, but no mucosal or skin lesions recurred. In March 2008, the patient was free from any mucosal or skin lesions on a combination therapy of prednisolone 5 mg daily and dapsone 75 mg daily.