What Am I Dealing With? Confusion Or Co-Association

Relationship between ocular cicatricial pemphigoid (OCP) and ocular surface squamous neoplasia.

One middle aged female patient with already diagnosed OCP under medications   underwent phacoemulsification +IOL both eyes and post Phaco doing well 

after six months she subsequently developed conjunctival squamous neoplasia. Her clinical histories ocular examinations, clinical photographs, and Impression cytology studies were carefully reviewed. Patient had a pre-invasive squamous dysplasia in Right Eye in the setting of OCP with bilateral conjunctivitis, symblepharons, and forniceal (fornix) shortening. The patients had been receiving intensive immunotherapy consisting of some combination of corticosteroids, Systemic Myco phenolate mofetil and topicals MMC 0.4% 2 cycles followed by interferon-alpha. Conjunctival Biopsy was advised but patient party refused to it and Right eye mass was resolved

 While rare, there are three previous reports of an association between OCP and conjunctival squamous neoplasia. The current report provides more data supporting the proposal that this conjunction is more than a random event. Conjunctival biopsy and immunofluorescent studies with strong clinical diagnosis are suggestive of OSSN as patient well respond with Topicals MMC and interferon.