Herpes gestationis. A clinicopathologic study

Abstract

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.

Bullous dermatoses of pregnancy

“…Clinically, the differential diagnosis of derma¬ titis herpetiformis, bullous pemphigoid, erythema multiforme, bullous drug eruptions, and papular dermatitis of pregnancy may be difficult.27"' Herpes gestationis was initially thought to be related to dermatitis herpetifor¬ mis. [3][4][5][6][7][8][9] Only in the past few years, with the aid of immunofluorescence microscopy techniques, has resemblance to bullous pemphigoid been seen. (Fig 2, top).…”