Synblepharon from Cicatricial Pemphigoid

Cicatricial pemphigoid is a chronic scarring and immunobullous disease that is characterized by multiple erosions on the oral mucosa, synechiae on the mucous membranes (including the synblepharon as depicted above) of the eye, mouth, vaginal areas and anus as well as erosions, scarring alopecia and tense bullae on the skin.  

The root cause of CP is autoantibodies which are directed against the basement membrane proteins, specifically the proteins which are found in the lamina lucida.  The usual presentation is one of oral mucosal lesions that have been present for years, with the appearance sometimes of a desquamative gingivitis, and it is most common in elderly females.