Gestational pemphigoid

Gestational pemphigoid (GP) is a rare autoimmune variant of the skin disease bullous pemphigoid, and first appears in pregnancy. It presents with tense blisters, small bumps, hives and intense itching, usually starting around the navel before spreading to limbs in mid-pregnancy or shortly after delivery. The head, face and mouth are not usually affected. It may flare after delivery before resolving around three to six months after the pregnancy. It can be triggered by subsequent pregnancies, menstrual periods and oral contraceptive pill. A molar pregnancy and choriocarcinoma can provoke it. In some people, it persists long-term. It is associated with premature delivery of a small baby, a few who may be born with blisters and urticaria, which generally resolves within six weeks. It does not spread from one person to another, and does not run in families. Diagnosis is by visulaization, biopsy and immunofluorescence. It can resemble pruritic urticarial papules and plaques of pregnancy, erythema multiforme, drug reactions and blistering scabies. Around 1 in 20,000 to 50,000 pregnancies are affected. It was originally called herpes gestationis because of the blistering appearance, although it is not associated with the herpes virus.