Pemphigoid gestationis

Epidemiology

• 1 in 50,000 pregnancies

Clinical Manifestations

• Very itchy bullous or vesicular rash
• Typically starts periumbilically and spreads
• Starts in the second half of pregnancy, may flare post-partum

Diagnosis

• Skin biopsy

Management

• Prednisolone 0.5 mg/kg/d into the postpartum period, then titrate down
  • May flare post-partum
• Second-line is azathioprine

Prognosis and Complications

• 10% risk of neonatal pemphigoid
• Associated with other autoimmune disorders