Active Gestational Pemphigoid in the Post-Partum or Post-Abortion Period
Pemphigoid gestationis does not always resolve at delivery. In some patients, disease remains active or flares following childbirth or pregnancy loss — presenting a distinct clinical situation that requires its own first-line management approach.
Clinical Scenario
This protocol targets pemphigoid gestationis presenting with ongoing active disease in the post-partum or post-abortion setting — specifically outside of the antenatal period. The absence of pregnancy-related prescribing constraints shapes which options are appropriate at this stage.
Treatment Approach (First-Line)
Management at this stage centres on a topical therapeutic strategy aimed at controlling active skin involvement. Additional symptomatic measures may be incorporated alongside this approach. The complete protocol — including agent selection, escalation criteria, and sequencing — is available via the link below.
References
DOI: 10.3389/fmed.2020.604945
In the post-partum/post-abortion period, we suggest as first step treatment immunosuppressant/immunomodulating agents, including dapsone and azathioprine, leaving as second choices IVIg and rituximab due to pharmacoeconomic reasons.
In analogy to bullous pemphigoid, high potency topical corticosteroids are proposed as first-choice treatment both in mild disease and in moderate-to-severe PG.
Even there is proven evidence, oral antihistamines can be used for itch management.
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