Herpes gestationis associated with choriocarcinoma

Herpes gestationis (HG) is a rare, vesicobullous dermatosis of pregnancy or the puerperium. It has been associated with hydatid mole and the use of oral contraceptives. Reports of HG and choriocarcinoma are extremely rare: only two cases have been reported. Metastatic choriocarcinoma, followed by a pruritic, bullous eruption, developed in a 36-year-old woman. A biopsy specimen of the lesions showed subepidermal bullae, with an eosinophilic infiltrate. Direct immunofluorescent microscopic findings showed IgG and C3 deposition at the basement membrane zone, establishing the diagnosis of HG. Methotrexate therapy produced a cure of the carcinoma and a simultaneous resolution of the skin lesions. To our knowledge, this is the first report of the association of HG and choriocarcinoma with immunofluorescent microscopic findings.