Background: Pemphigoid gestationis (PG), also known as herpes gestationis, is an uncommon autoimmune blistering disease that almost always occurs in the third trimester of pregnancy. The sudden emergence of the disease, its clinical appearance and the course create great stress on the pregnant woman and the fetus. The disease has been associated with premature delivery and small-for-gestational-age infants. Corticosteroids remain the mainstay of therapy.

Case: A pregnant woman presented with a diffuse blistering and intensely pruritic urticarial plaques that occurred periumbilically and spread to the rest of the body. We report a well-documented case of PG and an overview of the current understanding of the disease.

Conclusion: A multidisciplinary approach for diagnosis, treatment and course of the disease from both dermatologic and gynecologic viewpoints is suggested.

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Objective: To evaluate the maternal and fetal outcomes of 12 pregnant women diagnosed with pemphigoid gestationis, in conjunction with a review of the literature.

Methods: A retrospective review was conducted on the medical records of 12 patients diagnosed with pemphigoid gestationis who presented  between January 2014 and January 2024.

Results: Twelve pregnant patients with pemphigoid gestationis were included in the study.

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Gestational pemphigoid is a rare, autoimmune, subepidermal bullous disease with an incidence of 1 in 50,000 pregnancies, displaying itself through pruritic erythema and urticarial papules and plaques that evolve into tense bullae. Histopathological findings consist of subepidermal vesicles with perivascular eosinophils and lymphocytes, and direct immunofluorescence reveals C3 complement and, more rarely, IgG in a linear band along the basement membrane. The course is usually self-limiting within 6 months after delivery but, later, can be triggered by subsequent pregnancies, menstruation, or treatment with oral contraceptives.

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Gestational pemphigoid is a rare autoimmune skin condition specific to pregnancy and the postpartum period, with a variable course. There are currently no standardized guidelines referring to evidence-based therapeutic strategies. Intravenous immunoglobulin (IVIG) has recently emerged as a safe and effective steroid-sparing option as a second-line treatment for cases refractory to conventional steroid therapy and for managing relapses.

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Article Synopsis
  • Pregnancy leads to significant changes in a woman’s skin, particularly on the face and trunk, due to hormonal, mechanical, and immune factors.
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