Pemphigoid gestationis is a rare skin blistering disorder that occurs in women of childbearing age. It usually occurs in pregnancy but can also recur in women who subsequently take oral contraceptive therapy or with menstruation. It usually starts with an itchy rash that develops into blisters. It is commonest during mid to late pregnancy (the second and third trimesters). It was previously known as herpes gestationis but this name has been abandoned as there is no association with herpes virus infection.
Pemphigoid gestationis is an auto-immune blistering disease which basically means that an individual’s immune system starts reacting against his or her own skin causing skin splitting and blistering. Female hormones (particularly oestrogen) are thought to aggravate the reaction and this may be why it often presents during pregnancy when oestrogen levels rise.
Pemphigoid gestationis may recur in subsequent pregnancies and also may recur in some women who go on to take oral contraceptive therapy or during menstruation when their periods re-start following pregnancy.
There is also a link with other auto-immune diseases which may run in the family such as thyroid disease and pernicious anaemia.
There is no cure for pemphigoid gestationis. It can be suppressed with treatment, and symptoms often improve towards the end of pregnancy but then 80% of women will experience a flare of the rash around the time of delivery. In most cases symptoms resolve days or weeks after giving birth, but in some women the disease can remain active for months or years and may require continued treatment.
Newborns from pemphigoid gestationis affected mothers may have a temporary rash at birth, but usually have no long lasting affects.