Pemphigoid gestationis: a rare case and review

Area of Science:

• Dermatology
• Immunology
• Obstetrics

Background:

• Pemphigoid gestationis is a rare autoimmune blistering disease associated with pregnancy.
• Estimated incidence is 1:50,000 pregnancies.
• The exact pathogenic trigger remains elusive, but IgG1 auto-antibodies against BPA2 are key.

Observation:

• A 29-year-old pregnant woman presented with characteristic skin findings at 29 weeks gestation.
• She delivered a male infant with extensive bullae and denuded skin areas.
• Direct immunofluorescence confirmed pemphigoid gestationis in both mother and son.

Findings:

• This case documents a rare instance of maternal transfer of pemphigoid gestationis to the infant.
• The immunologic mechanism involves IgG1 auto-antibodies and the 180 kD BPA2.
• Infant involvement in pemphigoid gestationis is exceedingly rare.

Implications:

• This case underscores the possibility of in utero or perinatal transmission of pemphigoid gestationis.
• Further research into pathogenic mechanisms may improve understanding and management.
• Highlights the importance of diagnostic confirmation via direct immunofluorescence in suspected cases.