Pemphigoides gestationis
| Classification according to ICD-10 | |
|---|---|
| O26.4 | Herpes gestationis |
| ICD-10 online (WHO version 2019) | |
The gestational pemphigoid is a rare autoimmune bullous skin disease, which in the pregnancy occurs, usually the second or third trimester . It is also known as herpes gestationis because of the similar skin findings , but herpes viruses are not involved in the disease. The condition is so rare that the largest study conducted on treatment only includes 87 patients.
Clinical picture
Pemphigoides gestationis usually begins with blistering around the navel before it spreads to the rest of the skin. Occasionally, painful overheated urticaria also occurs. The local release of histamine causes severe itching .
causes
The causes of the disease are largely unknown; autoimmune involvement with deposition of C3 and immunoglobulin G at the dermal - epidermal junction is certain.
Differential diagnoses
The diagnosis is confirmed by direct immunofluorescence from skin biopsies and the serological detection of antibodies. Otherwise, the disease can easily be confused with the much more common PUPPP , especially if it occurs during the first pregnancy. However, the PUPPP usually begins in the fields of stretch marks and heals within 2 weeks after birth.
treatment
Treatment is usually immunosuppressive with corticosteroids . During the therapy, the number of autoantibodies and blistering decreases. However, therapy is difficult and often takes several months. There is no definitive cure for the disease, but remission does occur . Therefore, the psychological stress caused by this disease should also be included in the treatment.
Sick pregnant women should be examined for further pregnancy complications, in particular a lack of amniotic fluid should be excluded.
literature
- ^ RE Jenkins, S. Hern, MM Black: Clinical features and management of 87 patients with pemphigoid gestationis . In: Clinical and Experimental Dermatology . tape 24 , no. 4 , July 1999, p. 255-259 , doi : 10.1046 / j.1365-2230.1999.00472.x , PMID 10457123 .
- ↑ Jean L. Bolognia, Joseph L. Jorizzo, Ronald P. Rapini: Dermatology . Elsevier Health Sciences, 2003, ISBN 978-0-323-02578-2 , pp. 451 ff . ( limited preview in Google Book search).
- ↑ BP180NC16a ELISA May Be Useful in Serodiagnosis of Pemphigoid Gestationis. Medscape : June 21, 2005.
- ^ LA Castro, RB Lundell, PK Krause, LE Gibson: Clinical experience in pemphigoid gestationis: report of 10 cases . In: Journal of the American Academy of Dermatology . tape 55 , no. 5 , November 2006, pp. 823-828 , doi : 10.1016 / j.jaad.2006.07.015 , PMID 17052488 .
