Penfigoide del embarazo: a propósito de un caso clínico y revisión de la literatura / Pemphigoid gestationis: a case report and literature review

El penfigoide del embarazo (PE), denominado también penfigoide gestacional (PG) o herpes gestationis (HG), es una enfermedad ampollar autoinmunitaria poco frecuente asociada al embarazo. Usualmente ocurre durante o tercer trimestre de la gestación, pero puede presentarse en cualquier etapa de ésta e incluso en el puerperio. La enfermedad tiene un inicio súbito, con placas eritematosas anulares urticariales sobre la que se desarrollan ampollas, las que progresan a vesículas y bulas intensamente pruriginosas. Presentamos el caso clínico de una embarazada con una erupción papuloampollar cuya clínica e histopatología fueron concordante con penfigoide del embarazo.

Pemphigoid of pregnancy also called pemphigoid gestationis (PG) or herpes gestationis (HG) is a rare autoinmune bullous disease associated with pregnancy. It usually occurs during second or third trimester of gestation but can occur at any stage of it and even in the postpartum period. The disease has a sudden onset, with erythematous annular urticarial plaques on which blister develop, envolving into vesicles and bullae intensely itchy. We report the case of a pregnant woman with a rash of papules and blisters whose clinical and histopathology were consistent with pemphigoid gestationis.

Pemphigoid gestationis: clinical and laboratory evaluation

INTRODUCTION: Pemphigoid gestationis, also known as herpes gestationis, is a rare autoimmune blistering disease associated with pregnancy. It usually occurs during the second or third trimester, but it may be present at any stage of pregnancy or the puerperium. The clinical, histologic, and immunopathological features of pemphigoid gestationis are similar to those of the pemphigoid group of disorders. METHODS: We hereby report seven patients who were diagnosed with pemphigoid gestationis and followed at the Autoimmune Blistering Disease Clinic in the Department of Dermatology of the University of Sao Paulo Medical School between 1996 and 2008. DISCUSSION: Demographic and clinical findings, such as median age, sites of involvement, and gestational age of onset of our patients, coincide with those described in previous reports. The majority of patients (85 percent) exhibited complement C3 or C3 and immunoglobulin G (IgG) deposition along the basement membrane zone (BMZ) on immunofluorescence. Herpes gestationis factor (HG) factor was postitive in four out of six patients (67 percent), and three out of five patients recognized the bullous pemphigoid recombinant antigen (BP180) by ELISA. CONCLUSION: This study revealed a good outcome of the newborns from pemphigoid gestationis affected mothers, based on the absence of pemphigoid gestationis cutaneous lesions, mean birth weight, and normal Apgar scores and gestational age at birth.

Pápulas y placas urticarianas pruriginosas del embarazo: antecedentes de ingesta de quinidina con fines abortivos / Pruritic urticarial papules and plaques of pregnancy: history of quinidine ingestion for abortive objetives

Se comunica un caso de pápulas y placas pruriginosas del embarazo (P.P.U.P.E.), asociada a la ingesta de quinidina con fines abortivos en el primer trimestre del embarazo. No hemos encontrado relación entre la medicación ingerida por la paciente y la muerte fetal ocurrida en el preparto, sin poder descartar totalmente la posibilidad de un cambio antigénico en el feto. Realizamos algunas consideraciones sobre la clasificación propuesta por diversos autores con el objeto de simplificarla respecto a las afecciones específicas del embarazo. Nuestra paciente presentó un cuadro clínico evolutivo típico de la patología que describimos con una remisión total de sus lesiones en el puerperio inmediato. Este trabajo presenta otro caso de P.P.U.P.E. que parece negar el rol causal atribuido al sobrepeso materno y la distensión abdominal