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Journal of Gynecology Obstetrics and... May 2022Pemphigoid gestationis (PG), also known as gestational pemphigoid, as it is specifically associated with a pregnancy event, is among the rare pregnancy-related... (Review)
Review
Pemphigoid gestationis (PG), also known as gestational pemphigoid, as it is specifically associated with a pregnancy event, is among the rare pregnancy-related dermatoses, characterised by the formation of autoantibodies against Bullous Pemphigoid antigens 180 and 230 (BP180 and BP230), causing significant damage to the basement membrane of the skin, resulting in marked pruritus and blisters on the abdomen and extremities. Diagnosis of PG is basically made by the characteristic clinical picture and confirmed by immunofluorescence studies and histopathology of a skin biopsy. Treatment, just as for other autoimmune dermatoses, is achieved by corticosteroids with the risk of relapses in subsequent pregnancies. Fetal growth restriction and pre-maturity are potential fetal complications associated with the disease, hence the recommended combined antenatal care by a dermatologist as well as an obstetrician, however, this disease is unlikely to be a source of significant maternal morbidity or mortality.
Topics: Autoantibodies; Female; Humans; Pemphigoid Gestationis; Pregnancy; Pregnancy Complications; Prenatal Care; Pruritus
PubMed: 35385801
DOI: 10.1016/j.jogoh.2022.102370 -
Seminars in Diagnostic Pathology May 2017Several dermatoses are typified by the formation of spaces (blisters; bullae) within or beneath the epidermis. These may be acellular or filled with particular species... (Review)
Review
Several dermatoses are typified by the formation of spaces (blisters; bullae) within or beneath the epidermis. These may be acellular or filled with particular species of inflammatory cells. Etiological categories include infectious, immune-mediated, genetic, drug-related, and idiopathic lesions. Examples of such disorders include impetigo, Herpes virus infections, pemphigus, bullous pemphigoid and pemphigoid gestationis, epidermolysis bullosa acquisita, IgA-related dermatoses, inherited epidermolysis bullosa variants, Hailey-Hailey disease, and porphyria cutanea tarda. Other conditions manifest microscopic acantholysis within the surface epithelium but are not associated with clinical bullae, such as Darier disease and Grover disease. Finally, both infectious and non-infectious causes exist for the development of neutrophilic pustules in the epidermis, as seen in pustular psoriasis, Sneddon-Wilkinson disease (subcorneal pustular dermatosis), and acute generalized exanthematous pustulosis. This review considers the clinical and histological features of all of these diseases.
Topics: Humans; Skin Diseases, Vesiculobullous
PubMed: 28108048
DOI: 10.1053/j.semdp.2016.12.001 -
Skin Therapy Letter 2014The pregnancy-specific skin disorders are pruritic, inflammatory eruptions. The current classification by Ambros-Rudolph et al. includes four entities: pemphigoid...
The pregnancy-specific skin disorders are pruritic, inflammatory eruptions. The current classification by Ambros-Rudolph et al. includes four entities: pemphigoid gestationis (PG), polymorphic eruption of pregnancy (PEP), atopic eruption of pregnancy (AEP), and intrahepatic cholestasis of pregnancy (ICP). Although these disorders are all characterized by intense pruritus during pregnancy, they can be distinguished by timing, morphology, histopathology, treatment and potential for fetal complications. Diagnosis is made by clinical presentation, histology, and immunofluorescence. PEP and AEP typically resolve without sequelae; however, PG may lead to prematurity and low birth weight, and ICP is associated with an increased risk of prematurity, fetal distress, and intrauterine fetal demise. The potential for serious fetal complications necessitates a thorough evaluation of pregnancy-related pruritus. This article will discuss the skin disorders specific to pregnancy, with a focus on clinical presentation, potential for fetal complications, pathogenesis, diagnosis, and treatment.
Topics: Female; Fetal Diseases; Fluorescent Antibody Technique; Humans; Pregnancy; Pregnancy Complications; Pruritus; Skin Diseases
PubMed: 25405676
DOI: No ID Found -
JAAD Case Reports Nov 2023
PubMed: 37842158
DOI: 10.1016/j.jdcr.2023.08.013 -
Clinical and Experimental Dermatology Oct 2019Pemphigoid diseases are autoimmune subepidermal blistering diseases affecting the skin and mucous membranes, which are caused by autoantibodies targeting structural... (Review)
Review
Pemphigoid diseases are autoimmune subepidermal blistering diseases affecting the skin and mucous membranes, which are caused by autoantibodies targeting structural hemidesmosomal proteins or hemidesmosome-associated proteins. Variants of pemphigoid can be differentiated based on targeted antigens and clinical aspects. In this review, we will discuss pemphigoid variants that predominantly affect the skin, and provide clinicians with clues to diagnosis.
Topics: Epidermolysis Bullosa Acquisita; Female; Humans; Linear IgA Bullous Dermatosis; Pemphigoid Gestationis; Pemphigoid, Bullous; Pregnancy
PubMed: 31099084
DOI: 10.1111/ced.13984 -
Der Hautarzt; Zeitschrift Fur... Feb 2017The specific dermatoses of pregnancy represent a heterogeneous group of inflammatory skin diseases related to pregnancy and/or the postpartum period. A clinically... (Review)
Review
The specific dermatoses of pregnancy represent a heterogeneous group of inflammatory skin diseases related to pregnancy and/or the postpartum period. A clinically relevant classification has been well established over the past 10 years and includes pemphigoid gestationis, polymorphic eruption of pregnancy, intrahepatic cholestasis of pregnancy, and atopic eruption of pregnancy. The hallmark of all four entities is severe pruritus that is accompanied by characteristic skin changes. While some of these dermatoses are distressing only to the mother because of pruritus, others may be associated with significant fetal risks. Early diagnosis and prompt treatment are therefore essential. In this review, we discuss in detail pemphigoid gestationis, polymorphic and atopic eruptions of pregnancy whereas intrahepatic cholestasis of pregnancy is discussed in a separate article (Kremer A, Ständer S, DOI 10.1007/s00105-016-3923-y ). Furthermore, we present a helpful algorithm for diagnosis and management of pruritus in pregnancy.
Topics: Algorithms; Cholestasis, Intrahepatic; Dermatitis, Atopic; Evidence-Based Medicine; Female; Humans; Pemphigoid Gestationis; Pregnancy; Pregnancy Complications; Pruritus; Skin Diseases; Treatment Outcome
PubMed: 28074212
DOI: 10.1007/s00105-016-3922-z -
La Revue Du Praticien Apr 2017Skin and pregnancy. Skin manifestations during pregnancy are common and diversified. Physiological changes are the most frequently reported. These changes mainly include...
Skin and pregnancy. Skin manifestations during pregnancy are common and diversified. Physiological changes are the most frequently reported. These changes mainly include hyperpigmentation, cutaneous signs of vascular proliferation or congestion, and striae distensae. Regression is spontaneous in post-partum but total clearance can be incomplete. Eventual treatment of resistant changes is reported until delivery or end of lactation. Specific dermatoses of pregnancy include polymorphic eruptions of pregnancy, atopic eczema of pregnancy, intrahepatic cholestasis and pemphigoid gestationis. It is mandatory, in any eczema-like or urticaria-like pruritic dermatose of pregnancy, to rule out pemphigoid gestationis, a rare auto-immune dermatose, by performing skin biopsy with direct immunofluorescence or an ELISA BP 180-NC16A. In case of generalized pruritis, serum bile salts levels should be tested in order to rule out intrahepatic cholestasis.
Topics: Breast Feeding; Cholestasis, Intrahepatic; Female; Humans; Lactation; Pregnancy; Pregnancy Complications; Skin; Skin Diseases
PubMed: 30512886
DOI: No ID Found -
BMJ Case Reports Jun 2018
Topics: Adult; Antipruritics; Female; Histamine H1 Antagonists; Humans; Hydroxyzine; Pemphigoid Gestationis; Prednisone; Pregnancy; Pruritus
PubMed: 29914905
DOI: 10.1136/bcr-2018-225242 -
Journal of the American Academy of... Jul 2023
Topics: Pregnancy; Female; Humans; Pruritus; Pemphigoid Gestationis; Pregnancy Complications
PubMed: 37187427
DOI: 10.1016/j.jaad.2023.05.016 -
Clinics in Dermatology 2016Polymorphic eruption of pregnancy (PEP), a specific dermatosis of pregnancy also known as pruritic urticarial papules and plaques of pregnancy (PUPPP), is a benign,... (Review)
Review
Polymorphic eruption of pregnancy (PEP), a specific dermatosis of pregnancy also known as pruritic urticarial papules and plaques of pregnancy (PUPPP), is a benign, self-limited skin disorder. Key features include an increased prevalence in primigravidas, onset in the third trimester, remission near the time of delivery, and association with multiple gestation pregnancy. The clinical features are crucial to diagnosis. Histopathology is nonspecific, and immunofluorescence studies help differentiate PEP from pemphigoid gestationis. The pathogenesis of PEP remains elusive, and relevant theories are reviewed. There are no associated maternal or fetal risks, and treatment is largely symptomatic.
Topics: Female; Gravidity; Humans; Pregnancy; Pregnancy Complications; Pregnancy, Multiple; Prognosis; Pruritus; Sex Factors
PubMed: 27265077
DOI: 10.1016/j.clindermatol.2016.02.011