Synonym: Pemphigoid gestationis
NOTE: This is a noninfectious, autoimmune disorder that has no association with Herpes simplex or Herpes zoster.
Clinical features:
(1) onset may be during pregnancy or in the postpartum period
(2) intensely pruritic erythematous papules and plaques over
(2a) the abdomen
(2b) the chest
(2c) the back
(2d) the palms of the hands and soles of the feet
(3) large vesicles and/or bullae are common
(4) the condition tends to recur on subsequent pregnancies
(5) the newborn may show transient skin lesions
(6) exacerbations may occur in patients
(6a) on exposure to oral contraceptives or hormone replacement therapy
(6b) during menstrual periods
(6c) with hormone-producing tumors
Skin biopsy shows:
(1) perivasculitis about the dermal blood vessels with chronic inflammatory cells and eosinophils
(2) intraepidermal vesicles may be present
(3) basal cell necrosis may be present, typically over the dermal papillae
(3) bullae are subepidermal.
Immunofluorescence testing of a skin biopsy shows a linear band of C3 and IgG along the basement membrane of normal-appearing and lesional skin.
Diagnosis typically requires exclusion of other pruritic conditions.
