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Background
This is a blistering disease of pregnancy, closely related to bullous pemphigoid. It appears during the second or third trimester of pregnancy or rarely in the immediate postpartum period. It may occasionally skip subsequent gestations. A pruritic papulovesicular eruption starts around the umbilicus and spreads to the abdomen and thighs. The rash may resemble erythema multiforme or eczema with erythematous papules and plaques.
SYNONYMS Herpes gestationis
DISEASE ASSOCIATIONS CHARACTERIZATION Trophoblastic disease Trophoblastic tumor
Hydatidiform mole
ChoriocarcinomaHLA DR3 and DR4 Strong association
HISTOLOGICAL TYPES CHARACTERIZATION General Subepidermal bullous dermatosis with eosinophils VARIANTS
SPECIAL STAINS/IMMUNOPEROXIDASE/OTHER CHARACTERIZATION Special stains Direct immunofluorescence (DIF) Consistent linear complement C3 deposits at dermal epidermal junction
IgG less frequent
Indirect immunofluorescence (IIF) Circulating complement fixing autoantibodies (HG factor)
React with BP180 (NC16A2 and NC16A2.5 domain) and less frequently BP230
These are IgG1 and IgG3 subclass which are the strongest complement binding IgG
Electron microscopy (EM) J Am Acad Dermatol 1987;17:539-556
Clin Invest 1988;81:2023-2026
Last Updated 2/2/2001
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