Pemphigoid gestationis (herpes gestationis)
Overview
Pemphigoid gestationis (formerly known as herpes gestationis) is a rare autoimmune blistering skin disease that develops during pregnancy or shortly after childbirth. It occurs when the immune system mistakenly produces autoantibodies that attack proteins in the basement membrane between the epidermis (outer layer of the skin) and dermis (deeper layer of the skin), causing inflammation and blister formation. Despite its historical name, pemphigoid gestationis is unrelated to herpes virus infection. The condition most commonly begins during the second or third trimester of pregnancy but may also develop in the postpartum period.
Common Symptoms
Itchy red bumps and fluid-filled blisters resembling a hive-like rash present in the trunk and abdomen, and large raised patches on the skin. Symptoms may improve or go away during pregnancy, but most females have a flare around the time of delivery. PG may occur again once menstruation starts, and in certain cases, the condition can last for months or years after pregnancy.
Coexisting Diseases and Conditions
Risk Factors and Prevalence
The median age of onset for PG is around 26-32 years. Recurrences of PG in pregnancies subsequent to the pregnancy of onset are common, and when this occurs the disease is usually more severe and occurs earlier during the pregnancy. The subsequent use of oral contraceptives may also cause the disease to flare up again.
Recent Research
- Severe pemphigoid gestationis responsive to intravenous immunoglobulins after initial treatment failure of combined oral steroids and cyclosporin (2021)
- Treatment of autoimmune bullous disease during pregnancy and lactation: A review focusing on pemphigus and pemphigoid gestationis (2020)
- Managing pemphigoid gestationis (2020)
- Pemphigus vulgaris in pregnancy (2020)
Sources
- Sources
Lu, P. D., Ralston, J., Kamino, H., & Stein, J. A. (2010). Pemphigoid gestationis. Dermatology online journal, 16(11), 10.
Agostinis, P., & Antonello, R. M. (2020). Pemphigoid Gestationis. The New England journal of medicine, 383(9), e61. https://doi.org/10.1056/NEJMicm2000922
Fania, L., Guerriero, C., Ricci, F., Gagliano, M. F., & De Simone, C. (2017). Herpes gestationis and oral contraceptive: Case report and review of the literature. Dermatologic therapy, 30(5), 10.1111/dth.12518. https://doi.org/10.1111/dth.12518.
Jenkins, R. E., Hern, S., & Black, M. M. (1999). Clinical features and management of 87 patients with pemphigoid gestationis. Clinical and experimental dermatology, 24(4), 255–259. https://doi.org/10.1046/j.1365-2230.1999.00472.x.
Al-Fouzan, A. W., Galadari, I., Oumeish, I., & Oumeish, O. Y. (2006). Herpes gestationis (Pemphigoid gestationis). Clinics in dermatology, 24(2), 109–112. https://doi.org/10.1016/j.clindermatol.2005.10.011
Sävervall, C., Sand, F. L., & Thomsen, S. F. (2017). Pemphigoid gestationis: current perspectives. Clinical, cosmetic and investigational dermatology, 10, 441–449. https://doi.org/10.2147/CCID.S128144.