Expectant blistering

RASHES in pregnancy always cause concern. When the rash occurs suddenly and is associated with blistering, then the autoimmune disease pemphigoid gestationis should be considered.

This rash looked more like a severe contact dermatitis clinically. 

A skin biopsy with direct immunofluorescence studies was performed to see if IgG or C3 were deposited on the basement membrane, causing the epidermis to separate from the dermis and result in the blister formation. 

Sometimes in pemphigoid gestationis, antibodies can cross the placenta and attack the baby’s skin as well and there is a small increase in fetal mortality. However, any lesions on the baby’s skin at birth rapidly resolve without sequelae. 

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