| Gestational pemphigoid | |
|---|---|
| Other names | Pemphigoid gestationis, herpes gestationis[1] |
 | |
| Micrograph of gestational pemphigoid showing the characteristic subepidermal blisters and abundant eosinophils. HPS stain. | |
| Specialty | Dermatology |
| Symptoms | Blisters, itch, hives[1] |
| Complications | Premature delivery of a small baby, a few who may be born with blisters and urticaria[1] |
| Usual onset | Middle of pregnancy or shortly after[1] |
| Duration | Around 6-months[1] |
| Causes | Autoimmune[1] |
| Risk factors | Pregnancy, molar pregnancy, choriocarcinoma, oral contraceptive pill[1] |
| Diagnostic method | Appearance, skin biopsy, immunofluorescence[1] |
| Differential diagnosis | Pruritic urticarial papules and plaques of pregnancy, erythema multiforme, drug reactions, blistering scabies[1] |
| Treatment | Corticosteroid[1] |
| Frequency | 1 in 20,000 to 50,000 pregnancies[1] |
Gestational pemphigoid (GP) is a rare autoimmune variant of the skin disease bullous pemphigoid, and first appears in pregnancy.[2] It presents with tense blisters, small bumps, hives and intense itching, usually starting around the navel before spreading to limbs in mid-pregnancy or shortly after delivery.[1] The head, face and mouth are not usually affected.[3]
It may flare after delivery before resolving around three to six months after the pregnancy.[1] It can be triggered by subsequent pregnancies, menstrual periods and oral contraceptive pill.[1] A molar pregnancy and choriocarcinoma can provoke it.[1] In some people, it persists long-term.[1] It is associated with premature delivery of a small baby, a few who may be born with blisters and urticaria, which generally resolves within six weeks.[3] It does not spread from one person to another, and does not run in families.[3]
Diagnosis is by visulaization, biopsy and immunofluorescence.[4] It can resemble pruritic urticarial papules and plaques of pregnancy, erythema multiforme, drug reactions and blistering scabies.[1]
Around 1 in 20,000 to 50,000 pregnancies are affected.[1] It was originally called herpes gestationis because of the blistering appearance, although it is not associated with the herpes virus.[3]
- ^ a b c d e f g h i j k l m n o p q r James, William D.; Elston, Dirk; Treat, James R.; Rosenbach, Misha A.; Neuhaus, Isaac (2020). "21. Chronic blistering dermatoses". Andrews' Diseases of the Skin: Clinical Dermatology (13th ed.). Edinburgh: Elsevier. pp. 464–465. ISBN 978-0-323-54753-6. Archived from the original on 21 March 2022. Retrieved 2022-03-15.
- ^ Wakelin, Sarah H. (2020). "22. Dermatology". In Feather, Adam; Randall, David; Waterhouse, Mona (eds.). Kumar and Clark's Clinical Medicine (10th ed.). Elsevier. pp. 686–687. ISBN 978-0-7020-7870-5. Archived from the original on 2022-03-21. Retrieved 2022-03-21.
- ^ a b c d "Pemphigoid (herpes) gestationis". www.BAD.org.uk. British Association of Dermatologists. November 2020. Archived from the original on 2 February 2020. Retrieved 21 March 2022.
- ^ Johnstone, Ronald B. (2017). "6. Vesiculobullous reaction pattern". Weedon's Skin Pathology Essentials (2nd ed.). Elsevier. p. 123. ISBN 978-0-7020-6830-0. Archived from the original on 2021-05-25. Retrieved 2022-03-21.