Pemphigoid gestationis: a case report

Abstract

Case description: Pemphigoid gestationis is a rare autoimmune bullous disease occurring in pregnant women. The disease presents in the second or third trimester of pregnancy or during the postpartum period. A 31 year-old woman, G2P1, at 18 weeks and two days of gestation, presented at an urgent consultation with generalized pruritus. She was treated initially with a first generation oral anti-histaminic without improvement. When symptoms worsened and a periumbilical eruption appeared, the patient consulted with several doctors in different institutions and received a number of different diagnoses. One month later, she was diagnosed with pemphigoid gestationis and began treatment with intravenous corticosteroids. During the pregnancy, several attempts were made to reduce the dose of oral corticosteroids without success. On the third day postpartum there was a flare-up of the disease. The patient still presents with skin blisters to this day. It is important for family physicians to be aware of this condition, to know how to perform a relevant clinical examination, and to refer the pregnant woman with these complaints for additional testing to exclude other diagnoses. It is also important to be alert to the possibility of recurrence in subsequent pregnancies, in which the condition may appear earlier and with greater severity.