Chapter 59 Pemphigoid Gestationis Flashcards
associated in babies w/ slight increase
in premature and small for gestational age births
during what part of pregnancy
later part or immediate postpartum
anti BMZ antibody (formerly called HG factor or IgG) induces ___ deposition
C3
nearly all have antibodies to
BP180 (type XVII collagen)
BP 230 coded for on the short arm of
chromosome 6
BP180 coded on long arm of
chromosome 10
Increase in antigens?
DR3 and DR4
Only source of disparate HLA antigens is typically the ?
placenta (primarily paternal)
autoantibody of gestational pemphigoid binds to ?
amniotic BM
from fetal ectoderm, antigenically similar to skin
disease initiated by aberrant expression of
MHC calss II antigens (paternal haplotype) w/ in placenta
associated w/ what disease?
H moles and choriocarcinoma
occurs during _____ pregnancy
late
first onset on which area of the body?
abdomen often within or immediately adjacent to umbilicus
rapid progression to a generalized pemphigoid-like eruption sparing the ___
face, mucous membranes, palms and soles is the rule
flares occur during which part of pregnancy?
delivery (approx 75%)
newborns may be affected up to __% of the time
10%
mild and self-limited
differentiate BP from PG
BP - elderly, no gender bias
PG - strong association w/ HLA-DR3, -DR4, C4 null allele (not in BP)
PG - titer of anti-BMZ antibody usually so low (BP high)
BP - react to an intracellular 230-240kDa component of hemidesmosome while
PG - 180-kDa transmembrane protein
typical lesions of PG
urticarial or arcuate plaques rapidly progress toward mixed dermatitis including tense pemphigoid like blisters
Histopathology
subepidermal vesicle w/ lymphocytes and eosinophils
most constant histologic feature of PG
eosinophils
special test show
C3 w/ or w/o IgG along BMZ of perilesional skin
salt split skin specimen shows
antibody deposition along bottom of epidermal fragment (similar in BP)
Increased incidence of _______ antibodies documented in those w/ history of PG
antithyroid antibodies (clinically apparent thyroid dysfunction rare)
differential diagnosis
urticarial pemphigoid gestationis
PUPPP
Contact dermatitis (ACD)
drug eruption