Shaw Caroline J, Wu Pensee, Sriemevan Amir
Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, UK.
BMJ Case Rep. 2011 May 12;2011:bcr0220113915. doi: 10.1136/bcr.02.2011.3915.
Impetigo herpetiformis or gestational pustular psoriasis can account for 4.25% of all pregnancy dermatoses seen. Unlike other pregnancy dermatoses, it can be associated with constitutional symptoms including fever, rigors, arthralgia and complications of secondary infection and sepsis. There is an increased risk of fetal anomalies and stillbirths. A 25-year-old para 1 presented to primary care at 7 weeks gestation with a peri-umbilical rash non-responsive to topical steroids and underwent hospital admission at 31 weeks gestation with fever and a widespread painful erythematous rash. Her condition worsened despite high-dose oral steroids. With the use of cyclosporine and regular opioid analgesia over 2 weeks, her symptoms were adequately controlled. She went into spontaneous labour at 41(+2) weeks and delivered a healthy male infant. Impetigo herpetiformis can be treated first line with topical and oral steroids and supportive measures, but immunomodulatory therapies such as cyclosporine have shown success in treating resistant cases.
疱疹样脓疱病或妊娠脓疱型银屑病占所有妊娠皮肤病的4.25%。与其他妊娠皮肤病不同，它可能伴有全身症状，包括发热、寒战、关节痛以及继发感染和败血症的并发症。胎儿出现异常和死产的风险增加。一名25岁经产妇，孕7周时因脐周皮疹对局部类固醇治疗无反应而到基层医疗就诊，孕31周时因发热和广泛的疼痛性红斑皮疹入院。尽管使用了大剂量口服类固醇，她的病情仍恶化。通过使用环孢素和定期阿片类镇痛治疗2周后，她的症状得到了充分控制。她在41（+2）周时自然分娩，产下一名健康男婴。疱疹样脓疱病的一线治疗方法是局部和口服类固醇以及支持性措施，但免疫调节疗法如环孢素已被证明在治疗耐药病例方面取得了成功。
