Pemphigus, pregnancy, and plasmapheresis

Area of Science:

• Dermatology
• Immunology
• Obstetrics

Background:

• Pemphigus vulgaris (PV) is a rare autoimmune blistering disease affecting desmosomal proteins.
• It can occur during pregnancy, posing risks to both mother and fetus, including neonatal pemphigus (NP).

Observation:

• A pregnant woman presented with severe, widespread mucocutaneous blistering consistent with PV.
• Her condition worsened despite initial management.

Findings:

• Successful treatment was achieved using a combination of systemic corticosteroids and plasmapheresis.
• Plasmapheresis effectively removed pathogenic antibodies without significant immunosuppression.

Implications:

• PV should be considered in pregnant women with unexplained blistering disorders.
• Plasmapheresis is a viable and potentially safer therapeutic option than traditional immunosuppressants during pregnancy.