Herpes gestationis (HG)¹ is a pruritic polymorphic inflammatory dermatosis of pregnancy and the postpartum period. It is an autoimmune process with circulating complement-fixing IgG antibodies in the serum. It creates severe discomfort for the affected, but it is debated whether fetal prognosis is impaired.
Etiology unknown. The C3 deposition at the basement membrane and HG factor suggest an immunologic mechanism similar to that in bullous pemphigoid. It is postulated that IgG antibodies arise in response to antigenic stimulus peculiar to pregnancy, perhaps in the amnion. These antibodies have specificity for a 180-kDa antigen, a hemidesmosomal peptide. Antibodies deposited on the basement membrane zone activate the complement cascade, which in turn generates an inflammatory response.
Relationship between HG and bullous pemphigoid is unresolved. This relationship is suggested by the morphologic similarity of lesions, similar immunopathology, and the fact that the HG antigen is very closely related to, if not identical with, the 180-kDa bullous pemphigoid antigen.
Hormonal factors undoubtedly play an important role. Onset in pregnancy or thereafter, postpartum flares, and exacerbations with hormone-producing tumors or contraceptives.
* Initially there are itchy red bumps around the belly button.
* Some patients may have no blisters but instead have plaques (large raised patches)
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