Pemphigoid Gestationis

(Herpes Gestationis)

ByAntonette T. Dulay, MD, Main Line Health System
Reviewed/Revised Apr 2024

Pemphigoid gestationis is a rare, intensely itchy rash that occurs during or just after pregnancy.

  • Typically, the rash starts around the navel, appears during the second or third trimester, and disappears within a few weeks or months after delivery.

  • Usually, the baby is unaffected, although some develop a similar rash, which disappears without treatment within a few weeks.

  • Doctors usually diagnose pemphigoid gestationis based on what the rash looks like.

  • The rash is treated with a corticosteroid cream or, if it is severe, with a corticosteroid taken by mouth.

Pemphigoid gestationis is thought to be caused by abnormal antibodies that attack the body's own tissues—an autoimmune reaction. This disorder is relatively rare.

Symptoms of Pemphigoid Gestationis

The rash of pemphigoid gestationis can begin as flat or raised red spots that often first form on the abdomen around the navel. Then blisters develop and the rash spreads. The blisters are small or large, irregularly shaped, and fluid-filled. The rash is extremely itchy. The rash can spread to the rest of the body, including the trunk, arms, legs, palms, and soles. The face and mouth are usually not affected.

The rash usually appears during the second or third trimester. However, it may appear earlier or immediately after delivery. Typically, the rash worsens soon after delivery and disappears within a few weeks or months. It often reappears during subsequent pregnancies and sometimes reappears if the woman later takes oral contraceptives. It can also reappear while women are having their period or when their ovaries release an egg (at ovulation).

Usually, the baby is unaffected. But occasionally, the baby is born with a similar rash, which usually disappears without treatment within a few weeks. Also when women have pemphigoid gestationis, the risk of problems, including death of the baby, are increased if the baby is born prematurely or has not grown as much as expected (intrauterine growth restriction).

Diagnosis of Pemphigoid Gestationis

  • A doctor's evaluation

  • Sometimes a skin biopsy

Pemphigoid gestationis is diagnosed based on the rash's appearance. Sometimes doctors take a sample of skin from the affected area (skin biopsy) and test it for abnormal antibodies.

Treatment of Pemphigoid Gestationis

  • Corticosteroids

  • Antihistamines

Antihistamines that do not cause drowsiness, taken by mouth, can also be used to relieve the itching.

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