Herpes gestationis is a pruritic, blistering eruption of pregnancy and the puerperium. In three patients with immunologically verified disease, the clinical presentation consisted of widespread erythematous, edematous papules and plaques, grouped vesicles on erythematous bases, and tense bullae. Histologically, these lesions showed a moderately dense, mixed-inflammatory cell infiltrate around superficial and deep dermal blood vessels, and focal necrosis of epidermal basal cells. Papillary dermal edema, subepidermal bullae, and spongiosis were prominent. Eosinophils were frequently present in the subepidermal and intrepidermal vesicles. Differentiation of herpes gestationis from other blistering diseases and other dermatitides of pregnancy may be difficult.
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