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Pemphigoid Gestationis

  • Elizabeth M. Moore
  • Victoria P. WerthEmail author
Chapter

Abstract

Pemphigoid gestationis (PG) is an autoimmune blistering disease that occurs during pregnancy or soon after delivery. It is possibly caused by cross-reactivity between placental antigens and collagen XVII in the skin. Patients typically present with an intensely pruritic, vesiculobullous rash that starts periumbilically and spreads outwards across the trunk and extremities. Treatment is with immunosuppressive agents; however, given that PG is very rare—estimated to occur in 1 in 50,000 pregnancies—there is a paucity of evidence around specific treatments. Treatment of PG is also complicated by the need to consider the health of the fetus. Often, evidence for the use of immunosuppressant medications in pregnant women for other diseases can be extrapolated to PG. We review the literature and present an algorithm for treatment in the pre- and post-partum periods for women with PG based on the evidence available. We also list areas of focus for the future.

Keywords

Pemphigoid Gestationis PG Autoimmune Blistering Pregnancy BP180 

Abbreviations

ABSIS

Autoimmune Bullous Skin Disorder Intensity Score

BP

Bullous pemphigoid

DIF

Direct immunofluorescence

ELISA

Enzyme-linked immunosorbent assay

IA

Immunoadsorption

IIF

Indirect immunofluorescence

LBW

Low birth weight

LHRH

Luteinizing hormone releasing hormone

PDAI

Pemphigus Disease Area Index

PG

Pemphigoid gestationis

TSH

Thyroid stimulating hormone

Notes

Acknowledgements

This material is supported by the Veterans Health Administration, Office of Research and Development, Biomedical Laboratory Research and Development.

Funding Sources

None

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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Department of DermatologyUniversity of PennsylvaniaPhiladelphiaUSA
  2. 2.Department of DermatologyCorporal Michael J. Crescenz Veterans Affairs Medical Center, University of PennsylvaniaPhiladelphiaUSA
  3. 3.Department of DermatologyPerelman Center for Advanced MedicinePhiladelphiaUSA

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