Authors: Rita Chan Noble, MD, Heirich Manalili, MD, Elisabeth Ryan, MD, Ma. Teresita G. Gabriel, MD, FPDS


Introduction: Impetigo herpetiformis is a rare pustular disorder that affects pregnant women. It is also otherwise termed as “pustular psoriasis of pregnancy”, owing to the fact that the pustules are sterile and are not associated with a viral etiology. The classic lesions are erythematous patches or plaques studded with subcorneal pustules spreading centrifugally. A cardinal feature of this disorder is the rapid resolution of lesions after delivery. The complications of this disease include placental insufficiency, stillbirth or neonatal death.

Case Summary: This is a case report of a 33-year-old Filipino female, gravida 3, para 2 (2-0-0-2) at 36 weeks age of gestation who presented with one week history of multiple well defined irregularly shaped erythematous annular patches and plaques studded with pustules on the trunk and extremities. The lesions began on the trunk spreading centrifugally, sparing the face, palms, soles and mucus membrane. Biopsy showed scale crust in the stratum corneum, and neutrophilic microabscesses on the epidermis. A diagnosis of impetigo herpetiformis was given. Patient was started on systemic steroids and antihistamine with noted decrease in the number of lesions. Patient delivered via normal spontaneous delivery to a live baby girl with no noted complications. There was noted resolution of lesions after delivery.

Conclusion: Impetigo herpetiformis is one of the most common dermatoses of pregnancy. Early detection is of utmost importance to prevent maternal and neonatal complications. Management must be multidisciplinary involving a dermatologist, obstetrician and pediatrician.





Impetigo herpetiformis, pustular psoriasis of pregnancy

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