Fig 1.

Clinical images of El Bagre-endemic pemphigus foliaceus (EPF). A, Edema, erythema, and scaling of eyelids with severe ectropion. B, Hyperemia, edema, erythema, and conjunctival injection without mucoid discharge. C, Dry eye and atrophy of superior and inferior tarsal muscles. D, Catarrhal conjunctivitis-like alterations characterized by significant edema of superior and inferior eyelids. Small internal synechiae (as rare finding) resembling nasal ptyrigia in internal cantus of left eye. E, Most common clinical findings include meibomianitis of lower eyelid and partial occlusion of meibomian ducts. F (as in B), Hyperemia, edema, erythema, and conjunctival injection, in this case with mucoid discharge. A, D, C, and F, Thinning of eyebrows.