title: A case of recurrent impetigo herpetiformis treated with systemic corticosteroids and narrowband UVB.
abstract: Impetigo herpetiformis is a rare pustular eruption with usual onset during the third trimester of pregnancy. The disease tends to remit after delivery, but may recur in subsequent pregnancies. Here we present a recurrent case of impetigo herpetiformis with earlier onset and poor response to corticosteroids in the subsequent pregnancy. She had widespread, erythematosquamous patches with tiny superficial pustules in the third trimester of her first pregnancy. Histopathological and clinical findings were consistent with impetigo herpetiformis. She was treated with systemic prednisolone and had a healthy baby without any complication. Three years later, the patient presented with impetigo herpetiformis again in the second trimester of her second pregnancy. After six weeks of oral prednisolone treatment, the lesions improved, but there were still new pustule formations and narrowband ultraviolet B treatment was added. Skin eruption cleared and she had a healthy baby in the 38th week of her second pregnancy. The corticosteroid dose was tapered gradually and stopped after delivery. Early diagnosis and treatment is crucial in impetigo herpetiformis because of the risk of maternal and fetal complications. When prednisolone is not enough to control the eruption alone, narrowband UVB can safely be added to the treatment.
authors.affiliation: Department of Dermatology, Ataturk Education and Research Hospital, Izmir, Turkey. bozdagk@gmail.com
authors.forename: Kubra
authors.initials: K
authors.lastname: Bozdag
authors.forename: Serap
authors.initials: S
authors.lastname: Ozturk
authors.forename: Murat
authors.initials: M
authors.lastname: Ermete
mesh_terms: D000328:Adult; D003874:Dermatitis Herpetiformis / Q000175:diagnosis / Q000188:drug therapy* / Q000532:radiotherapy; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007169:Impetigo / Q000175:diagnosis / Q000188:drug therapy* / Q000532:radiotherapy; D011239:Prednisolone / Q000627:therapeutic use*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000188:drug therapy* / Q000532:radiotherapy; D012008:Recurrence; D014467:Ultraviolet Therapy; D055815:Young Adult
chemical_list: D005938:Glucocorticoids; D011239:Prednisolone