ABSTRACT
Herpes gestationis (pemphigoid gestationis) is a rare autoimmune disease that appears during pregnancy or in the immediate postpartum period. We report the cases of a mother and neonate with immunofluorescence confirmed herpes gestationis both of whom had extensive cutaneous involvement.
Subject(s)
Autoimmune Diseases/diagnosis , Pemphigoid Gestationis/diagnosis , Autoimmune Diseases/congenital , Autoimmune Diseases/pathology , Basement Membrane/pathology , Blister/pathology , Complement C3/analysis , Eosinophils/pathology , Female , Fluorescent Antibody Technique, Direct , Humans , Immunoglobulin G/blood , Infant, Newborn , Male , Pemphigoid Gestationis/congenital , Pemphigoid Gestationis/pathology , PregnancyABSTRACT
Herpes gestationis (HG) is a rare autoimmune disease of pregnancy. We report on five patients in whom the clinical diagnosis was confirmed by histology, immunofluorescence and immunoblot studies. The time of onset ranged from the 8th week of pregnancy to the 1st day post partum. In one patient erosions and ulcerations of the oral cavity predominated while the remainder of the skin was nearly unaffected. One patient had intense pruritus without any skin eruptions during the final 8 weeks of her pregnancy, developing bullous lesions on the 1st day post partum. The other patients initially suffered from pruritic polymorphic skin lesions, followed by vesiculae and bullae. In the serum of all patients, the complement-fixing HG factor was found. Immunoblot studies with epidermal and dermal extracts demonstrated the binding of the antibodies to a 180-kD protein of the epidermis. All patients improved markedly with medium dosages of systemic corticosteroids. In four cases the newborns were healthy and mature, and in one case, the infant met all criteria for a "small-for-dates" baby. We discuss both clinical spectrum and diagnostic options of HG and review new aspects related to the pathogenesis of this disease.
