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JIFACTOR:Publisher: Peytchinski, Gospodin Iliev
ISSN: 1312 773X (Online)
Issue: 2014, vol. 20, issue 6
Subject Collection: Medicine
Pages: 552-555
DOI: 10.5272/jimab.2014206.552
Published online: 10 December 2014
J of IMAB 2014 Oct-Dec;20(6):552-555
HERPES GESTATIONIS.
Ivelina Yordanova1 
, Valentin Valtchev1, Kossara Drenovska2, Dimitar K. Gospodinov1, Snejina Vassileva2.
1) Department of Dermatology and Venereology, Faculty of Medicine, Medical University, Pleven,
2) Department of Dermatology and Venereology, Faculty of Medicine, Medical University, Sofia, Bulgaria.
ABSTRACT:
Herpes gestationis, also known as pemphigoidgestationis (PG) is an extremely rare autoimmune bullous dermatosis of the gestation and postpartum period. The disease was originally named herpes gestationis on the basis of the morphological herpetiform feature of the blisters. We report a 21-year-old woman, pregnant in the third trimester, who presented with a pruritic bullous cutaneous eruption of two weeks duration. The disease started with a red plaque in the abdominal area accompanied by mild itching. Soonafter, blisters appeared and affected almost the entire body. Physical examination revealed a primiparous woman in good general state, pregnant in 36 weeks of gestation. The skin changes affected the abdomen, back of the trunk, upper and lower extremities, hands and feet. They were manifested by a polymorphous eruption, consisting of erythematous urticaria-like plaques, small tense vesicles and multiple excoriations. Mucous membranes were not affected. Routine laboratory examinations were within normal limits. Direct immunofluorescence (DIF) on perilesional skin showed linear deposition of IgG (++) and C3 (++) at the cutaneous basement membrane zone (BMZ). Indirect immunofluorescence (IIF) on human esophagus substrate revealed circulating IgG anti-BMZ antibodies at a titer of 1:80. ELISABP180 NC16A was strongly positive. The diagnosis of PG was confirmed and a treatment with systemic methylprednisolone 60 mg/day was initiated, later gradually tapered to 20 mg/day, together with topical corticosteroids. As a result on the 10th day of the treatment we already achieved significant improvement with reduction of erythema and itching, absence of new skin lesions. The pregnancy ended in term with successful childbirth. No flare of the skin disease was observed in the puerperal period.
Key words: Pemphigoid gestationis, herpes gestationis, pregnancy, direct and indirect immunofluorescence, methylprednisolone,
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Please cite this article in PubMed Style or AMA (American Medical Association) Style:
Yordanova I, Valtchev V, Drenovska K, Gospodinov DK, Vassileva S. Herpes gestationis. J of IMAB. 2014 Oct-Dec;20(6):552-555. http://dx.doi.org/10.5272/jimab.2014206.552
Correspondence to: Assoc. Prof. Ivelina Yordanova, PhD. MD, Department of Dermatology and Venereology, Faculty of Medicine, Medical University, Pleven; 91, Gen. Vladimir Vazov str., 5800 Pleven, Bulgaria; E-mail: ivelina_yordanova@abv.bg
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Received: 03 August 2014
Published online: 10 December 2014