Pemphigoid Gestationis in a 15 Year Old Pregnant Patient, A Case Report and Literature Review

Abstract

Pemphigoid gestationis, previously known as herpes gestationis, is a rare autoimmune bullous disease that manifests in pregnancy. Upon presentation, patients complain of intense pruritis, urticarial plaques, vesicles and bullae that primarily affect the peri-umbilical area before spreading to involve the rest of the body. The accurate diagnosis of pemphigoid gestationis is made histopathologically on biopsies, based on the presence of sub-epidermal vesicles, as well as direct visualization of linear deposition of C3 at the basement membrane zone by using immunofluorescence staining on those biopsies. The mainstay treatment of the disease remains corticosteroids. Prompt recognition and provision of the appropriate management allow a reduction in both maternal morbidity as well as fetal adverse perinatal outcomes. Pathologic skin dermatoses and diseases of pregnancy are rare and have different presentations, treatment and prognoses. This literature review includes an up to date comparison on the presentation, diagnosis and treatment of dermatoses in pregnancy, in order to help with the discrimination. A case of pemphigoid gestationis in a 15 year old woman is described. This is the youngest reported age of presentation of pemphigoid gestationis, raising the question of whether maternal age is a factor that can affect the course and the severity of the disease.