Korean J Obstet Gynecol.  2011 Dec;54(12):794-797. 10.5468/KJOG.2011.54.12.794.

A case of pemphigus vulgaris developed during pregnancy

• Kim JS
• Kim SK

• KMID: 1443944
• DOI: http://doi.org/10.5468/KJOG.2011.54.12.794

Abstract

Pemphigus vulgaris is an uncommon, autoimmune disease characterized by acantholysis and blister formation in the skin and mucosa. Pemphigus vulgaris during pregnancy is exceedingly rare. The disease may be associated with adverse neonatal outcome, including prematurity and fetal death. The clinical features of this patient were similar to those of pemphigoid gestationis. Circulating antibodies directed at desmosomal proteins may cross the placenta and place children at risk for neonatal pemphigus. Transient skin lesions may occasionally appear in the neonate. We report a case of pemphigus vulgaris in a 32-year-old pregnant woman who showed erythematous bullae, erosions and crusts on the whole body. She was diagnosed by clinical and histopathological findings, direct immunofluorescent test. This patient was treated with high dose of corticosteroids to control the disease.

Keyword

Pemphigus; Autoimmune diseases; Pregnancy

MeSH Terms

Acantholysis
Adrenal Cortex Hormones
Adult
Antibodies
Autoimmune Diseases
Blister
Child
Female
Fetal Death
Humans
Hypogonadism
Infant, Newborn
Mitochondrial Diseases
Mucous Membrane
Ophthalmoplegia
Pemphigoid Gestationis
Pemphigus
Placenta
Pregnancy
Pregnant Women
Proteins
Skin
Adrenal Cortex Hormones
Antibodies
Hypogonadism
Mitochondrial Diseases
Ophthalmoplegia
Proteins

Figure

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  Fig. 1 Multiple erythematous to dark red, annular or targetoid macules and plaques on the abdomen, especially around the umbilicus.

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  Fig. 2 Multiple tense vesicles and bullae on the erythematous base in the abdomen.

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  Fig. 3 An intraepidermal acantholytic blister has a suprabasal cleavage plane. Severe edematous change in the papillary dermis and inflammatory cell infiltration admixed with considerable amount of eosinophilis (H&E, ×100).

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  Fig. 4 There is lace-like squamous intercellular space deposition of C3 (A), immunoglobulin G (B) in the epidermis (direct immunofluorescence, ×200).

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