Pemphigoid gestationis is a rare condition which occurs during pregnancy and presents with large, itchy blisters all over the body.(Part two of a two-part series. Part one appeared January 23, 2002)
IN ADDITION to the normal physiological skin changes that occur during pregnancy,
there are some skin diseases which occur exclusively in pregnancy.
The pregnant woman may suddenly develop an itchy rash with or without jaundice. This is due to the hormonal changes in the liver which leads to an accumulation of bile salts. The itching is usually intense and can be very distressing to the mother but is not harmful to foetus or mother.
In first pregnancies, particularly during the last three months, red papules, plaques and weals may occur first on the abdomen along stretch marks then spread to involve the limbs. The rash is usually quite alarming but subsides following delivery and does not recur in subsequent pregnancies. The rash is usually quite alarming but subsides following delivery and does not recur in subsequent pregnancies.
Another condition called Prurigo gravidarum presents with groups of itchy, fine bumps during late pregnancy. It resolves with delivery but can recur with subsequent pregnancies.
In a rare condition called pemphigoid gestationis, the pregnant mother develops large itchy blisters all over the body, sometimes also in the mouth, as early as the fifth month. This may settle during the course of the pregnancy and flare again at the time of delivery. Although resolution occurs after delivery, the condition can recur with subsequent use of contraceptive and with the menstrual cycle.
Itching is the most common and distressing feature of these disorders. Treatment is aimed at relieving the discomfort and includes cool compresses, emollients, anti-itch lotion and in severe cases, oral anti-histamine.
Prompt medical attention is important in alleviating the extreme distress and anxiety associated with these
disorders
- Presenters: Drs. Pat Dunwell & Dian Robinson, consultant dermatologists
