Legoux A, Lambert D, Laurent R, Portier H, Mavel A
Sem Hop. 1982 Nov 25;58(43):2526-34.
The treatment of herpes gestationis has been considerably changed in recent years by progress in electron microscopy and immunology. Herpes gestationis, a rare polymorphic vesiculo-bullous pruriginous dermatosis, occurs during pregnancy or the post-partum period. It evolves by acute periods of several weeks, and relapses during later pregnancies or on taking oestro-progestagens. Histologically, the bulla is situated at the dermo-epidermic junction. The epidermal oedema is both intra and extra-cellular. The ultrastructural studies show the importance of the oedema and the changes in the plasma membrane of the basal cells in the onset of the vesicles and the bullae. The immunological inquiry gives diagnostic certainly when one discovers under indirect immuno-fluorescence, a specific serum factor, the herpes gestationis factor. These ultrastructural and immunological data suggest a relationship between herpes gestationis and bullous pemphigus (Lever's disease). In treatment, the possible pathogenic role of prolactin suggests the use of bromocriptin during the postpartum period. The efficacy and innocuity of vitamin B6 make corticosteroids rarely necessary.
近年来,随着电子显微镜技术和免疫学的进展,妊娠疱疹的治疗方法有了很大改变。妊娠疱疹是一种罕见的多形性水疱大疱性瘙痒性皮肤病,发生于妊娠期或产后。其病程呈急性发作数周,在随后的妊娠期间或服用雌激素 - 孕激素时复发。组织学上,水疱位于真皮 - 表皮交界处。表皮水肿既有细胞内的也有细胞外的。超微结构研究表明水肿以及基底细胞质膜变化在水疱和大疱形成过程中的重要性。当通过间接免疫荧光发现一种特异性血清因子——妊娠疱疹因子时,免疫学检查即可确诊。这些超微结构和免疫学数据提示妊娠疱疹与大疱性类天疱疮(利弗病)之间存在关联。在治疗方面,催乳素可能的致病作用提示在产后使用溴隐亭。维生素B6的有效性和安全性使得很少需要使用皮质类固醇。