关键词: 黏膜类天疱疮, 眼瘢痕性类天疱疮, 多学科团队协作, 糖皮质激素, 免疫抑制剂, 个体化治疗

Abstract: Objective: This case report describes the diagnosis and treatment process of a patient with mucous membrane pemphigoid (MMP) involving both oral and ocular regions, aiming to explore the multidisciplinary collaborative diagnosis and treatment strategy and the clinical outcomes of a stepped, individualized treatment regimen for high-risk MMP. Diagnosis and Treatments: The patient visited the Ophthalmology Department due to ‘congestion in both eyes and blurred vision’. He was advised to consult the Department of Oral Mucosa to rule out mucous membrane pemphigoid. A review of the medical history revealed that the patient developed gingival hyperemia two years ago, which did not receive treatment. The diagnosis of MMP was confirmed based on clinical examination, histopathology, and direct immunofluorescence. Treatment involved a stepped regimen of systemic glucocorticoids combined with immunosuppressants, underpinned by multidisciplinary management involving departments of oral medicine, ophthalmology, and endocrinology. Results: After 13 months of treatment, the oral lesions completely resolved, active ocular inflammation was effectively controlled, and symblepharon stabilized without progression. The systemic glucocorticoid dosage was successfully reduced to a maintenance dose of 6mg/d, creating conditions for subsequent ocular surgery. Conclusions: For high-risk MMP, early and accurate diagnosis is the prerequisite. An individualized, stepwise treatment strategy centered on systemic immunosuppression, with participation from multiple disciplines, is crucial for disease control, prevention of scar formation, and improvement of patient prognosis.

Key words: mucous membrane pemphigoid, ocular cicatricial pemphigoid, multidisciplinary team, glucocorticoids, immunosuppressants, individualized treatment