BACKGROUND: Pemphigoid gestationis is a rare autoimmune blistering disease that occurs during pregnancy. OBJECTIVE: This study reviewed our clinical experience with pemphigoid gestationis. METHODS: We reviewed medical records of 10 patients with pemphigoid gestationis seen at Mayo Clinic, Rochester, Minnesota, between 1976 and 2004. RESULTS: Urticarial papules were the most frequent clinical presentation followed by blisters and rash. Pruritus was the cardinal symptom. Lesions presented initially on the legs, thighs, back, and chest. Direct immunofluorescence had the highest diagnostic test sensitivity. Systemic corticosteroids were the mainstay of treatment. Fetal and maternal outcome was good in all cases. LIMITATIONS: This was a retrospective, single-institution study. CONCLUSIONS: This condition can be easily confused with other dermatoses of pregnancy, for example, pruritic urticarial papules of pregnancy. Biopsy for direct immunofluorescence is the preferred test for confirmation of diagnosis. On the basis of good patient outcomes, conservative treatment seems warranted.
BACKGROUND: Pemphigoid gestationis is a rare autoimmune blistering disease that occurs during pregnancy. OBJECTIVE: This study reviewed our clinical experience with pemphigoid gestationis. METHODS: We reviewed medical records of 10 patients with pemphigoid gestationis seen at Mayo Clinic, Rochester, Minnesota, between 1976 and 2004. RESULTS: Urticarial papules were the most frequent clinical presentation followed by blisters and rash. Pruritus was the cardinal symptom. Lesions presented initially on the legs, thighs, back, and chest. Direct immunofluorescence had the highest diagnostic test sensitivity. Systemic corticosteroids were the mainstay of treatment. Fetal and maternal outcome was good in all cases. LIMITATIONS: This was a retrospective, single-institution study. CONCLUSIONS: This condition can be easily confused with other dermatoses of pregnancy, for example, pruritic urticarial papules of pregnancy. Biopsy for direct immunofluorescence is the preferred test for confirmation of diagnosis. On the basis of good patient outcomes, conservative treatment seems warranted.
Authors: Megan H Noe; Kelly A N Messingham; Debra S Brandt; Janet I Andrews; Janet A Fairley Journal: J Reprod Immunol Date: 2010-05-14 Impact factor: 4.054