pregnancy dermatoses Flashcards
autoimmune bullous dermatosis of pregnancy; typically seen 2nd or 3rd trimester
starts periumbilical
pemphigoid gestationis (Herpes gestationis)
autoantibody in pemphigoid gestationis (Herpes gestationis)
BPAG2 (180kDa, NC16A site)
when can you see flares of pemphigoid gestationis (Herpes gestationis)
with delivery
OCPs
menses
pemphigoid gestationis (Herpes gestationis) pts have increased risk of…
graves dz
how to differentiate pemphigoid gestationis (Herpes gestationis) from PUPPP
DIF!
see linear C3 at BMZ
level of split + histology of pemphigoid gestationis (Herpes gestationis)
subepidermal (BPAG2 target) with eos, necrotic keratinocytes
SSS binding side of pemphigoid gestationis (Herpes gestationis)
epidermal
risk to fetus with pemphigoid gestationis (Herpes gestationis)
prematurity, SGA
up to 10% with skin involvement
HLAs a/w pemphigoid gestationis (Herpes gestationis)
DR3 and DR4
what predisposes to PUPPP
1st pregnancy
twins
maternal obesity
PUPPP distribution
within striae and SPARES periumbilical area
PUPPP and risk to fetus
none
excoriates papules and sometimes pustules over extensor surfaces, usually no bullae
prurigo of pregnancy
generalized pruritus in pregnancy worst at night and on trunk/plams/soles
cholestasis of pregnancy
labs to check with cholestasis of pregnancy
serum bile acids (if > 40, high risk for fetus)
treatment for cholestasis of pregnancy
ursodeoxycholic acid
pustules on erythematous base initially in intertriginous areas in pregancy
pustular psoriasis of pregancy (aka impetigo herpetiformis)
risk to fetus with pustular psoriasis of pregancy (aka impetigo herpetiformis)
placental insufficiency
what labs to check with pustular psoriasis of pregancy (aka impetigo herpetiformis)
hypocalcemia
elev ESR
leukocytosis
