Herpes gestationis (HG) is a rare pruriginous, blister-forming disorder that occurs, in most cases, in the second or third trimester of pregnancy (37). It can also occur in association with a cystic mole or a chorionic carcinoma (37). Both in pregnancy and in the presence of trophoblastic tumors, the immune system is confronted with foreign antigens of the sex partner, which may potentially play an important role in the pathogenesis of HG. In addition to a certain constellation of human leucocyte antigen (HLA) antigens in the mother and father, hormonal effects also have an important pathogenetic influence. For example, administering oral contraceptives with a high estrogen level to treat trophoblastic tumors cam exacerbate HG. Furthermore, the ovulation phase of the cycle may cause an exacerbation of HG, possibly because of estrogen's immunostimulating effects at certain concentrations (37). In most patients, however, an exacerbation of HG occurs more frequently in the premenstrual phase, possibly because of the steep decline of the high progesterone level prior to the onset of menstrual bleeding. The clinical activity of HG during pregnancy is also dependent on hormonal changes. In the last weeks of pregnancy, for example, when the progesterone level is high, there is a relative remission of the cutaneous manifestations, which are exacerbated immediately after delivery, when the progesterone level decreases markedly (37).
Was this article helpful?