Abstract
A 36-year-old woman first developed generalized pruritic bullous eruptions and painful lingual ulcers five years previously. The initial diagnosis was pemphigus and she was treated with prednisolone at a maximum dose of 40 mg/day. Three years later, steroid administration was discontinued since all the lesions disappeared except for oral lesions. Five years later, in the second trimester of her pregnancy, pruritic bullous eruptions appeared again. Physical examination revealed the presence of dermatitis herpetiformis-like eruptions on her trunk and extremities. A histologic examination showed suprabasal bullae and eosinophilic spongiosis. A direct immunofluorescence study revealed the intercellular deposition of IgG and C3. Using immunoblot procedures, the patient’s sera reacted with 130kDa and lower molecular weight epidermal antigens. The patient’s serum also reacted with desmoglein 3 by ELISA. From these findings, the diagnosis of herpetiform pemphigus was made. The condition was well controlled by the administration of oral prednisolone 40 mg/day. At the 36th gestational week, she delivered a healthy girl with no blistering lesions. No postpartum worsening of her disease was noted.
