Pemphigoid gestationis associated with gestational trophoblastic neoplasia: A case report

Pemphigoid gestationis (PG) is well described in pregnancy, classically presenting as a pruritic, periumbilical rash in multiparous women in the second or third trimester. We describe a unique case of a woman with gestational trophoblastic neoplasia (GTN) status post dilation and curettage on methotrexate (MTX) who presented with a diffuse, pruritic rash. After the rash persisted and flared despite multiple cycles of MTX, biopsies were obtained supporting a diagnosis of PG. It is important to consider PG on the differential in non-pregnant patients with GTN with a persistent pruritic rash, even in the setting of ongoing treatment with MTX.