Estève Eric
CHR Orléans, hôpital Porte-Madeleine, service de dermatologie, rue Porte-Madeleine, 45032 Orléans cedex 1, France.
Presse Med. 2010 Oct;39(10):1071-5. doi: 10.1016/j.lpm.2009.09.032. Epub 2010 Aug 7.
Pemphigoid gestationis (PG) is a rare autoimmune bullous dermatosis associated with pregnancy. Its previous designation, herpes gestationis, is obsolete. PG is characterized by a subepidermic separation induced by the presence of peripheral blood autoantibodies against two hemidesmosomal antigens: BPAG1 and BPAG2. Clinical diagnosis is confirmed by histology and positive cutaneous immunofluorescence tests. The most discriminant examination for other pruritic dermatoses of pregnancy is the enzyme-linked immunosorbent assay (Elisa) NC16A BP 180. First-line treatment is local corticosteroid therapy; if local treatment fails, general corticosteroid therapy should be administered. The prognosis is good for mother and child, except that there is a risk of preterm delivery and of moderate fetal growth restriction. Management in a specialized setting is therefore necessary. Recurrence is possible during subsequent pregnancies.
妊娠类天疱疮(PG)是一种与妊娠相关的罕见自身免疫性大疱性皮肤病。它之前的名称“妊娠疱疹”已过时。PG的特征是外周血中针对两种半桥粒抗原(BPAG1和BPAG2)的自身抗体导致表皮下分离。临床诊断通过组织学和阳性皮肤免疫荧光试验得以证实。对其他妊娠瘙痒性皮肤病最具鉴别力的检查是酶联免疫吸附测定(ELISA)NC16A BP 180。一线治疗是局部糖皮质激素治疗;如果局部治疗失败,则应给予全身糖皮质激素治疗。除了有早产和中度胎儿生长受限的风险外,母婴预后良好。因此,需要在专业环境中进行管理。在随后的妊娠期间有可能复发。