Bullous pemphigoid of pregnancy: clinical picture, diagnostics, treatment

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Abstract

Pregnancy is a particular period in woman’s life. It accompanies with plenty of adaptation changes include many on skin. Pathological morphofunctional changes form a group of pregnancy-specific dermatoses.

The clinical case of bullous pemphigoid of pregnancy is presented in the article. The disease occurs during pregnancy or postpartum period. The incidence is estimated to be approximately 1 in 60,000 pregnancies. Clinically, PG is characterized by intense pruritus and polymorphic skin eruptions. Skin lesions develop including erythematous patches and plaques, followed by urticarial rash and blisters. Diagnosis of the disease is based on the features of the clinical picture, complex data of pathomorphological and immunological research methods, including direct or indirect immunofluorescence, enzyme-linked immunosorbent assay (ELISA), immunohistochemical determination of a fragment of the complement component C4d and determination of serum antibodies to BP180.

The most effective treatment is systemic glucocorticosteroids in combination with topical steroids and/or antihistamines. Timely diagnosing and prescribing appropriate medication are highly important in preventing intrauterine fetal suffering.

About the authors

Elena S. Snarskaya

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: snarskaya-dok@mail.ru
ORCID iD: 0000-0002-7968-7663
SPIN-code: 3785-7859
Scopus Author ID: 8714450500

MD, Dr. Sci. (Med.), Professor

Russian Federation, 8-2, Trubetskaya street, Moscow, 119992

Nikolay G. Kochergin

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: nkocha@yandex.ru
ORCID iD: 0000-0001-7136-4053
SPIN-code: 1403-3031

MD, Dr. Sci. (Med.), Professor

Russian Federation, 8-2, Trubetskaya street, Moscow, 119992

Eugenia V. Galaktionova

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Author for correspondence.
Email: galaktionova.doc@gmail.com
ORCID iD: 0000-0001-5851-9153

Student

Russian Federation, Moscow

Ksenia A. Vovdenko

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: vovdenkoksenia@ya.ru
ORCID iD: 0000-0003-1415-3940
SPIN-code: 8315-2175

аспирант кафедры

Russian Federation, Moscow

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2. Fig. 1. Patient A., pregnancy is 27–28 weeks: а ― condition upon admission to the clinic (widespread rashes all over the skin, blisters up to 1 cm in diameter, located on an erythematous background, with a thick tense lining and serous contents); б ― multiple vesicular-bullous eruptions in the neck; в ― on the skin of the hands, bubbles merge to form erosions.

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3. Fig. 2. Patient A., pregnancy is 27–28 weeks: а ― the condition of the skin on the 7th day of therapy: regression of rashes by 50–60%; б ― regression of rashes on the 7th day of therapy, residual hyperpigmentation.

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