Bullous Dermatoses in Pregnancy

Abstract

This paper reviews the clinics and therapy of some very rare constellations: autoimmune bullous diseases in pregnancy. In this context of the immunology of healthy pregnancy, the term of fetal-maternal tolerance and the consequences of the lost or damaged tolerance during early or late pregnancy will be briefly introduced. We will discuss the course of autoimmune blistering diseases during gravidity, their diagnosis, including differential from other gestational dermatoses and the possible fetal outcome. As the most common of the pregnancy-induced autoimmune blistering diseases, pemphigoid gestationis will be detailed, together with the significant development on fetal-maternal immunology and disease pathology. Management of patients with pemphigus and pemphigoid group of diseases as well as therapy, diet, and follow-up suggested for gravidas with dermatitis herpetiformis will be summarized. The current status and pregnancy safety categories of immunosuppressive and adjuvant treatment modalities will be highlighted.