The study suggests that similar surveys from different regions would expand our understanding of ABD.

Pemphigoid gestationis (PG) is a rare autoimmune disease of pregnancy. We report a series of 22 cases of PG in Kuwait. They constituted 18% of all the autoimmune bullous diseases registered in our centre over a span of 11 years. PG was observed to be the third most common bullous disease in our region. Ninety-five per cent of the patients were of Arab ethnicity. The clinical features observed in our patients were comparable to those reported elsewhere. Systemic steroids (prednisolone 20-60 mg daily) remained the mainstay of treatment to control the active disease and an optimal dose of 20 mg of prednisolone was maintained throughout the pregnancy and immediate postpartum period. We observed a favourable outcome of pregnancies complicated by PG without any associated maternal or foetal morbidity. Kuwaiti patients with PG were observed to have a predominance of HLA-DR3 and DQ2 antigens. No predominance of HLA-DR4 antigen was observed.

Erythema elevatum diutinum (EED) is a chronic form of leucocytoclastic vasculitis that presents with symmetrical plaques, papules, and nodules in an acral distribution. The treatment is conservative, with dapsone being the first choice among the drugs commonly used. However, the late lesions may not respond due to the marked fibrosis, and they are extremely stressful to the patient both symptomatically and cosmetically. A case of EED in a patient with history of splenectomy for idiopathic thrombocytopenic purpura (ITP) is presented, where the late cutaneous lesions were excised and skin grafted. The association with splenectomy and the use of skin grafting as a mode of treatment when all other modalities have failed, have not been reported previously. A review of the relevant literature is presented.