The dermatoses of pregnancy are various group of pruritic inflammatory dermatoses that be found particularly during pregnancy and/or in the immediate postpartum period. These include the these conditions, which are Pemphigoid gestationis, Polymorphic eruption of pregnancy (pruritic urticarial papules and plaques of pregnancy [PUPPP]), Atopic eruption of pregnancy (eczema in pregnancy, prurigo of pregnancy, pruritic folliculitis of pregnancy), Intrahepatic cholestasis of pregnancy (see “Intrahepatic cholestasis of pregnancy”), Pustular psoriasis of pregnancy.
Panel test
● Immunogenetics
o Associated with HLA-DR3 and DR4.
o C4 null alleles
● Immunopathology
o Pathology shows the presence of eosinophils, which may be accompanied by a peripheral blood eosinophilia.
o Staining on immuno-EM is localized to the epithelial lamina lucida.
o IIF is positive in only 30% of patients.
o Therefore, biopsy with DIF is the diagnostic test of choice.
● Autoantibodies:
o anti BPAg2 Ag autoantibody
Comments: DIF shows linear deposits of C3 at the dermo-epidermal junction in almost all cases, with IgG in up to 50%.
References
- Baum S, Sakka N, Artsi O, et al. Diagnosis and classification of autoimmune blistering diseases. Autoimmun Rev 2014; 13:482.
- Chan LS, Ahmed AR, Anhalt GJ, et al. The first international consensus on mucous membrane pemphigoid: definition, diagnostic criteria, pathogenic factors, medical treatment, and prognostic indicators. Arch Dermatol 2002; 138:370.
- Marazza G, Pham HC, Schärer L, et al. Incidence of bullous pemphigoid and pemphigus in Switzerland: a 2-year prospective study. Br J Dermatol 2009; 161:861.
- Schmidt E, della Torre R, Borradori L. Clinical features and practical diagnosis of bullous pemphigoid. Dermatol Clin 2011; 29:427.
