Pemphigoid Gestationis - Case Report and Review of Literature

Abstract

Pemphigoid gestationis (PG) is a rare autoimmune bullous skin disorder which usually presents with intense pruritus and urticarial lesions that may evolve into vesicles and tense blisters. In majority of patients, it starts in the second or third trimester of pregnancy and resolves spontaneously after delivery. Lesions appear in the periumbilical area in 90% of patients and rapidly spread centrifugally to other parts of the body. The diagnosis needs to be confirmed by direct immunofluorescence test (DIF) with indirect immunofluorescence test (IIF), ELISA and immunoblot techniques playing role in diagnosis and/or monitoring antibodies level. Mild symptoms of PG can be treated with topical therapy only, but in severe course of the disease the treatment may be escalated to oral corticosteroids. We present an unusual case of PG started 2 weeks after delivery with an updated overview on the epidemiology, pathology, clinical picture, treatment, and complications of the disease.

Keywords: case report; gestational pemphigoid; herpes gestationis; pemphigoid gestationis; pregnancy dermatoses.

Figure 1

(A and B) Erythematous, oedematous lesions with central erosions and single vesicular lesions. The eruption was presented mostly on the limbs, especially hands and feet, and a few on the trunk.

Figure 2

DIF demonstrated linear depositions of IgA (+), IgG (++), and C3 (+++) complement along the dermo-epidermal junction.