[Pemphigoid gestationis: a study of 15 cases].
BACKGROUND
Pemphigoid gestationis is a rare subepidermal bullous dermatosis generally occurring during the 2(nd) or 3(rd) quarter of gestation or in the postpartum period in women who already have been pregnant.


OBJECTIVE
The aim of this work is to draw a profile of the epidemiology, clinical aspects, treatment and evolution of the disease by studying hospital series.


METHODS
In this retrospective study, 15 cases of pemphigoid gestationis confirmed by direct immunofluorescence, followed in the department of dermatology between 1983 and 1999, were included.


RESULTS
The age of onset was 19 to 39 years (mean age: 30 years). In 73% of cases, pemphigoid gestationis occurred in women who had already been pregnant, and appeared during the last 3 months of gestation in 11 patients. In all cases, purities was the first symptom, followed by a erythematous maculopapular eruption. In the steady state of the disease, all patients had annular confluent erythematous papules with herpes, like vesicles predominant in the umbilicus. The diagnosis of pemphigoid gestationis was confirmed by direct immunofluorescence in all cases demonstrated linear staining of C3 at the basement membrane zone. Systemic corticosteroids (0.5-1mg/kg/day) were used in 54% of reported cases. Dapsone was efficient in 26% of patients. 20% of patients were treated with oral antihistamine and topical glucocorticoid. Recurrence occurred in postpartum in 53,3% of patients. Two patients had recurrence during the following pregnancies.


CONCLUSIONS
PG remains a rare dermatitis of pregnancy. Our series is comparable to the literature: the late occurrence of PG during the course of pregnancy, the high frequency of multigravida women, the lack involvement in the newborn, however with some particularities: the frequent involvement of the face and the efficiency of dapsone.
Boudaya
S
S
Service de Dermatologie, CHU Hédi-Chaker, 3029 Sfax, Tunisie.
Turki
H
H
Meziou
T J
TJ
Marrekchi
S
S
Bouassida
S
S
Zahaf
A
A
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D003622:Dapsone / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D005455:Fluorescent Antibody Technique; D006801:Humans; D010391:Pemphigoid, Bullous / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D012189:Retrospective Studies; D016896:Treatment Outcome; D014416:Tunisia / Q000453:epidemiology
D000305:Adrenal Cortex Hormones; D000894:Anti-Inflammatory Agents, Non-Steroidal; D003622:Dapsone