Pemphigus vulgaris in pregnancy.
We report the case of a 34-year-old woman who was diagnosed with pemphigus vulgaris (PV) during pregnancy. The patient presented with widespread blistering dermatitis and associated burning and pruritus. At 6 weeks' gestation the patient was admitted to the hospital to expedite her diagnosis and initiate treatment. A skin biopsy revealed suprabasal acantholysis, and direct immunofluorescence demonstrated diffuse intercellular IgG in the epidermis and basal intercellular C3, which confirmed the diagnosis of PV. Treatment with corticosteroids was instituted after discussions with the patient about possible adverse effects to the fetus. Pemphigus vulgaris is rare in pregnancy and active PV presents potential threats of fetal spread and transient lesion production, which is associated with increased mortality and morbidity in the fetus. Our patient had active PV and required treatment throughout her pregnancy. The pregnancy progressed to premature delivery of the neonate without skin lesions or apparent complications.
401 Parnassus Ave, San Francisco, CA 94143, USA. Kelsey.Walorinta@ucsf.edu.
Kelsey W
KW
Salzberg
Melanie J
MJ
Gero
Bruce D
BD
Ragsdale
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000009:adverse effects; D001706:Biopsy; D004305:Dose-Response Relationship, Drug; D005260:Female; D005455:Fluorescent Antibody Technique; D006801:Humans; D062072:Patient Acuity; D010392:Pemphigus / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D011241:Prednisone / Q000008:administration & dosage / Q000009:adverse effects; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000209:etiology*; D012867:Skin / Q000473:pathology; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D011241:Prednisone