gestational pemphigoid gestational pemphigoid gestational pemphigoid (gp) is a rare autoimmune variant of the skin disease bullous pemphigoid, and first appears in pregnancy. it presents with tense blisters, small bumps, hives and intense itching, usually starting around the navel before spreading to limbs in mid-pregnancy or shortly after delivery. the head, face and mouth are not usually affected. gestational pemphigoidother namespemphigoid gestationis, herpes gestationismicrograph of gestational pemphigoid showing the characteristic subepidermal blisters and abundant eosinophils. hps stain.specialtydermatologysymptomsblisters, itch, hivescomplicationspremature delivery of a small baby, a few who may be born with blisters and urticariausual onsetmiddle of pregnancy or shortly afterdurationaround 6-monthscausesautoimmunerisk factorspregnancy, molar pregnancy, choriocarcinoma, oral contraceptive pilldiagnostic methodappearance, skin biopsy, immunofluorescencedifferential diagnosispruritic urticarial papules and plaques of pregnancy, erythema multiforme, drug reactions, blistering scabiestreatmentcorticosteroidfrequency1 in 20,000 to 50,000 pregnancies it may flare after delivery before resolving around three to six months after the pregnancy. it can be triggered by subsequent pregnancies, menstrual periods and oral contraceptive pill. a molar pregnancy and choriocarcinoma can provoke it. in some people, it persists long-term. it is associated with premature delivery of a small baby, a few who may be born with blisters and urticaria, which generally resolves within six weeks. it does not spread from one person to another, and does not run in families. diagnosis is by visulaization, biopsy and immunofluorescence. it can resemble pruritic urticarial papules and plaques of pregnancy, erythema multiforme, drug reactions and blistering scabies. around 1 in 20,000 to 50,000 pregnancies are affected. it was originally called herpes gestationis because of the blistering appearance, although it is not associated with the herpes virus. signs and symptoms diagnosis of gp becomes clear when skin lesions progress to tense blisters during the second or third trimester. the face and mucous membranes are usually spared. gp typically starts as a blistering rash in the navel area and then spreads over the entire body. it is sometimes accompanied by raised, hot, painful welts called plaques. after one to two weeks, large, tense blisters typically develop on the red plaques, containing clear or blood-stained fluid. gp creates a histamine response that causes extreme relentless itching (pruritus). gp is characterized by flaring and remission during the gestational and sometimes post partum period. usually after delivery, lesions will heal within months, but may reoccur during menstruation. causes