Pemphigoid gestationis: Report of 44 cases

Abstract

Introduction: Pemphigoid gestationis (PG) is a rare autoimmune bullous dermatosis occurring during pregnancy and post partum. The aim of our study was to analyse epidemio-clinical, immunopathological, therapeutic and prognostic features of PG through a hospital study of 44 cases. Methods: It is a retrospective study, collecting all cases diagnosed at the dermatological department of Farhat Hached Soussa (Tunisia) from January 1990 to December 2015. Results: The disease began in 40,9% of cases at the second trimester of pregnancy and 48% at the third trimester of pregnancy, one case in post abortum. It was a polymorphic eruption, localized in the chest, the back and limbs in all cases. The face was affected in 18,2% of cases and the mucosa in one case. The skin biopsy showed a subepidermal blister in 25 cases. The direct immunofluoresence found linear C3 deposits along the basement membrane in all cases, associated to IgG deposits in 25% of cases. The treatment was mainly based on local or general corticotherapy with favourable evolution. We noted exacerbation in post partum in 17 cases and relapses during the ulterior pregnancies in 7 cases. Fetal damage was present in PG in 8 cases. Conclusion: Our study is conformed to literature data; nevertheless, it is distinguished by its appearance on the face the less frequency of palmo-plantar manifestations and the exceptional case of PG postabortum.