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GIORNALE ITALIANO DI DERMATOLOGIA E VENEREOLOGIA
A Journal on Dermatology and Sexually Transmitted Diseases
Official Journal of the Italian Society of Dermatology and Sexually Transmitted Diseases
Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,014
Giornale Italiano di Dermatologia e Venereologia 2001 April;136(2):135-45
Herpes gestationis (gestational pemphigoid). Up-dating and retrospective study of cases observed at the department of dermatological sciences of the University of Florence
Fabbri P., Mei S., Amato L., Berti S.
Università degli Studi - Firenze Clinica Dermosifilopatica II Dipartimento di Scienze Dermatologiche (Direttore: Prof. P. Fabbri)
The authors present, after a careful reviewing of literature, a retrospective study about overall HG survey (7 patients) identified by the Department of Dermatology of Florence in the last 20 years. The epidemiological characteristics of this survey are in agreement with the literature: the mean age of patients (34 years), the initial presentation of HG during the 25th-28th weeks gestation of the 2nd-3rd pregnancy, the appearance of a polymorphous dermatosis mainly located on abdomen (umbilical region) and characterized by pruritic, erythemato-oedematous, figured lesions, rarely associated with microvesicles. The histopathological findings of recent lesions rarely demonstrated the typical pattern of HG (subepidermal blister, infiltrate of eosinophils just below dermal-epidermal junction, focal areas of liquefaction degeneration of basal keratinocytes). More frequently an epidermal spongiosis with numerous vesicles and a dermal infiltrate of eosinophils and neutrophils have been demonstrated. Immunopathological findings of our cases are characteristic and revealed circulating IgG1 autoantibodies (in 2 out of 7 patients) and linear C3 deposit along basement membrane zone (BMZ) in all our patients. Immunoblotting (IB), performed in 2 patients, demonstrated that these autoantibodies recognize the BPAg2 only. The results of these immunopathological studies suggest the importance of: 1) Complement fixation test (CFT), demonstrating circulating autoantibodies also in patients with negative indirect immunofluorescence on monkey esophagus 2) Salt spilt skin (SSS), revealing circulating and fixed IgG1 autoantibodies only on epidermal side 3) IB, identyfing the antigen (BPAg2) recognized by the specific anti-BMZ antibodies of HG.