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Case Reports
. 2021 Dec 6;9(34):10645-10651.
doi: 10.12998/wjcc.v9.i34.10645.

Diagnosis, fetal risk and treatment of pemphigoid gestationis in pregnancy: A case report

Hai-Ning Jiao  1 , Ye-Ping Ruan  2 , Yan Liu  1 , Meng Pan  2 , Hui-Ping Zhong  3
Affiliations
Case Reports

Diagnosis, fetal risk and treatment of pemphigoid gestationis in pregnancy: A case report

Hai-Ning Jiao et al. World J Clin Cases. .

Abstract

Background: Pemphigoid gestationis (PG) is a rare autoimmune blistering disease that usually presents in the second or third trimester, with an incidence of 1 per 50000 pregnancies. PG tends to recur with an earlier onset and a more severe course in subsequent pregnancies. Skin biopsy markers can be confirmed by direct immunofluorescence staining.

Case summary: Our patient was diagnosed with PG at 8 mo of gestation with fresh bullous lesion marks on the abdomen and limbs. Termination of the pregnancy was performed by cesarean section at 37 + 4 wk of gestation. The patient delivered an infant weighing 3620 gm. The infant had urticaria-like and vesicular skin lesions and was diagnosed with PG. The patient was discharged on prednisolone and in a satisfactory condition. The infant was discharged after anti-inflammatory therapy for one week.

Conclusion: PG is a rarely reported disease, and 10% of newborns develop mild clinical symptoms consisting of urticaria-like or vesicular skin lesions. We intend to remind clinicians to consider this condition when a patient presents with such lesions so that treatment can be started early and neonatal morbidity can be taken into account.

Keywords: Case report; Fluorescent antibody techniqu; Newborn; Pemphigoid gestationis; Pemphigus; Pregnancy.

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Conflict of interest statement

Conflict-of-interest statement: The authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
Pemphigoid gestationis on the abdomen and limbs.
Figure 2
Figure 2
Skin with a sub-epidermal blister with eosinophils and lymphocytes within the cavity and in superficial dermis of pemphigoid gestationis in pregnancy (hematoxylin and eosin 100×).
Figure 3
Figure 3
Linear deposition of C3 along the basement membrane zone with the absence of IgG (direct immunofluorescence) of pemphigoid gestationis in pregnancy.
Figure 4
Figure 4
The first day after birth of the infant: Urticaria-like and vesicular skin lesions in neonatal pemphigoid gestationis.
Figure 5
Figure 5
Skin biopsy of the infant showed another layer of epithelium over the normal epithelium with eosinophils and lymphocytes infiltration.
Figure 6
Figure 6
Direct immunofluorescence of the infant showed linear deposits of C3 along the basement membrane zone similar to her mother.
Figure 7
Figure 7
The seventh day after birth of the infant.
See this image and copyright information in PMC

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