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From questions on page 422422

1. Describe the non-ocular findings

Figure 1B,C demonstrates cutaneous blistering on the plantar aspect of the foot and penis respectively, which were preceded by urticarial eruptions. The case demonstrates the importance of a full systemic examination of patients presenting with ocular manifestations, whereupon the diagnosis was only made from a penile biopsy. A decision not to perform a conjunctival biopsy was made to prevent any potential worsening of scarring and/or course of disease,2 although some reports suggest that bulbar conjunctival biopsies are safe and well tolerated in patients with MMP.3

2. What is the diagnosis based on the penile biopsy?

This is the direct immunofluorescence image. The semithin biopsy section demonstrates IgG deposition at …

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