Pemphigoid Rare Erythematous pruritic papules, Preterm birth, fetal gestationis plaques, vesicles, and bullae; growth restriction, abdomen often with umbilical transient neonatal involvement, extremities lesions this is mild placental insuiciency that stems from IgG and resolution is protracted, and disease may be exacerbated during complement deposition along the amnionic basement memmenses or by oral contraceptives (Semkova, 2009). brane (Huilaja, 2013). Accordingly, antepartum surveillance of afected pregnancies is reasonable.
In 5 to 10 percent of cases, IgG antibodies passively transfer Before bullae form, these lesions may resemble pruritic urtifrom the mother to cause similar skin lesions in the newborn carial papules and plaques of pregnancy. Other diagnoses (Erickson, 2002). hese eruptions in the neonate require only include pustular psoriasis, dermatitis herpetiformis, erythema wound care and clear spontaneously within a few weeks as the multiforme, linear 19A bullous dermatosis, urticaria, allergic passively acquired IgG levels decline. Slowly following contact dermatitis, bullous pemphigoid, and atopic eruption maternal lesions resolve without scarring, and most women are of pregnancy (LipozenCic, 2012). Drug-induced blistering disease-free after 6 months (Jenkins, 1999). In some, however, syndromes must also be excluded as some are life-threatening,
FIGURE 62-1 Pemphigoid gestation is. A. Abdominal plaques classically involve the umbilicus. B. Blistered lesions on the wrist and forearm. (Used with permission from Dr. Kara Ehlers.) for example, Stevens-Johnson syndrome and toxic epidermal necrolysis (Stern, 2012).
Skin biopsy and serum antibody assays are informative.
Immunofluorescent staining of a skin punch biopsy sample is the gold standard, and C3 complement and sometimes IgC are seen deposited along the basement membrane between the epidermis and the dermis (Katz, 1976). Also, in many cases, circulating IgC antibodies against collagen V1I can be detected in maternal serum (Powell, 2005; Sitaru, 2004).
Pruritus can be severe. Early in its course, topical highpotency corticosteroids and oral antihistamines may be efective. Oral prednisone, 0.5 to 1 mg/kg daily gradually tapered to a maintenance dose, may be needed for relief and also for inhibition of new lesions. Plasmapheresis, high-dose intravenous immunoglobulin (IVIC) therapy, or cyclosporine has been used in intractable cases (Huilaja, 2015; Ko, 2014; Van de Wiel, 1980).