A 30-year-old woman with congenital rickets and autosomal recessive ichthyosis developed impetigo herpetiformis in the second trimester of her first pregnancy. This condition was temporally related to her discontinuation of vitamin D supplements and subsequent hypocalcemia. No associated systemic symptoms were observed, and a healthy baby was delivered prematurely at 34 weeks' gestation. This report supports the association between hypocalcemia and impetigo herpetiformis and raises theoretical questions regarding a relationship between vitamin D metabolism and various epidermal hyperproliferative states.