Bullous dermatoses of pregnancy

Abstract

Eight women had a bullous skin disease that occurred during pregnancy. One patient had clinical, histopathologic, and immunopathologic features of pemphigus. The other seven patients showed the features of herpes gestationis. Oral contraceptives reproduced the disease in the pemphigus patient and in one of the others. When the pemphigus patient was free of active disease, local intraepidermal acantholytic blister formation with deposition of IgG and C3 in the intercellular substance of the epidermis was induced by intradermal injection of progesterone.

An unusual association of pemphigus vulgaris with hyperprolactinemia

“…Pemphigus vulgaris (PV) is a well‐established, autoimmune, intraepidermal, blistering disorder of the skin and mucous membranes characterized by circulating autoantibodies directed against the 130‐ and 85‐kDa antigens on the keratinocyte cell surface. Several reports of its coexistence with other autoimmune diseases, such as rheumatoid arthritis, Sjogren's syndrome, systemic lupus erythematosus (SLE), and scleroderma, neoplasms, such as thymomas, lymphoreticular malignancies, etc., and therapeutic agents, such as penicillamine, captopril, progesterone, or vaccines, have been documented in the literature 1–5 . In vivo and in vitro studies performed in these cases have suggested various etiologic mechanisms, including the dysregulation of the immune response by the drug or disease, with an increased tendency to antibody formation in genetically predisposed individuals 6,7 …”

The role of T lymphocytes and cytokines in the pathogenesis of pemphigoid gestationis

“…Direct immunofluorescence (DIF) shows in 100% of patients a linear C3 deposit along the basement membrane zone (BMZ) 6–8 and in 40–50% an immunoglobulin (Ig)G deposit with the same morphology 6,7 , 9 . Indirect immunofluorescence (IIF) demonstrates in 20–60% of cases circulating IgG autoantibodies against BMZ antigens, 6,10 but complement fissation test (CFT) reveals these specific autoantibodies in 90% of PG subjects 6,8 , 10–17 . The anti‐BMZ autoantibodies produced by PG subjects are predominantly of the IgG1 subclass 18 .…”

Gender Differences in Vesiculobullous Autoimmune Skin Diseases

“…This autoimmune epidermal blistering disease is characterized by acantholysis caused by IgG autoantibodies against desmoglein (Dsg). Pemphigus vulgaris (PV), vegetans, or foliaceus may present or worsen during pregnancy, especially in the first and second trimesters 8,9 . Menstruation may also induce or cause a relapse of pemphigus.…”