Pemphigoid gestationis

Question 1

Pemphigoid gestationis

Answer 1

Also known as pregnancy-related bullous pemphigoid, gestational pemphigoid and herpes gestationis.

Question 2

Pemphigoid gestationis: Incidence

Answer 2

1 in 1700 and 1 in 50 000 pregnancies

Question 3

Pemphigoid gestationis: timing of symptoms

Answer 3

Any time after the second trimester and, rarely, immediately after childbirth

Question 4

Pemphigoid gestationis: Symptoms

Answer 4

• Rash usually appears around the umbilicus as urticarial papules and plaques, which join to form bullae, extending to involve the trunk, extremities, palms and soles with mucosal sparing
• Large, tense blisters can form after a few weeks around the edge of the rash or in otherwise unaffected areas of the skin

Question 5

Pemphigoid gestationis: diagnosis and natural course of the disease

Answer 5

• Biopsy taken from perilesional skin
• Exacerbations and remissions are characteristic
• The course of the disease shows frequent improvement towards delivery followed by a flare-up at the time of delivery
• May recur in subsequent pregnancies
• Earlier onset and increasing severity
• Also may recur with OCP and menstruation