Bullous impetigo and pregnancy: Case report and review of blistering conditions in pregnancy.
BACKGROUND
Bullous impetigo results from Staphylococcus aureus (S. aureus) release of exfoliative toxins type A and type B thatresults in flaccid, easily ruptured, bullae in the upper layers of the epidermis.  Physiologic, gestation-associated, and incidental skin changes can occur in pregnancy.  Blisters in pregnant women can occur secondary to either common skin disorders orspecific dermatoses of pregnancy.


OBJECTIVE
To describe a pregnant woman with bullous impetigo and review bullous conditions in pregnant women.


METHODS
PubMed was used to search the following terms, separately and in combination:  blister, blistering, bullous, gestationis, herpes, herpetiformis, impetigo, pemphigoid, pregnancy, pregnant, psoriasis, pustular, virus. All papers were reviewed and relevant manuscripts, along with their reference citations, were evaluated.


RESULTS
Flaccid, easily rupturing, pustules, which developed into superficial annular erosions with peripheral scale and central healing appeared in a woman of 7-weeks gestation and allergy to penicillin on her lower abdomen, suprapubic region, perineum, buttocks, and proximal legs.  A bacterial culture subsequently isolated methicillin-susceptible S. aureus.  All of the lesions resolved after treatment with clindamycin.


CONCLUSIONS
Bullous impetigo should be considered in the differential diagnosis of common skin diseases presenting as blistersin pregnant women.
Department of Dermatology, University of California San Diego. mitehead@gmail.com.
Philip R
PR
Cohen
D000293:Adolescent; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007169:Impetigo / Q000175:diagnosis*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis*; D012872:Skin Diseases, Vesiculobullous / Q000175:diagnosis; D013207:Staphylococcal Skin Infections / Q000175:diagnosis*