impetigo herpetiformis (IH)

Last reviewed 03/2020

  • Impetigo herpetiformis (IH) is a rare dermatosis of pregnancy

  • natural course of IH is commonly resolved in the postpartum period

  • typically presents during the third trimester of pregnancy and resolves during the postpartum period

  • has been called psoriasis of pregnancy - there is a clinical and histological resemblance to psoriasis

  • may recur in future pregnancies
    • matter of debate whether it represents a pustular form of psoriasis or a separate entity related to pregnancy in cases when there is no personal or family history of psoriasis, when the lesions clear during the postpartum period and never rebound, or when they recur in subsequent pregnancies

  • characteristic features are superficial pustules studded on the periphery of erythematous plaques

  • hypocalcaemia may be a precipitating factor

  • associated fetal complications include stillbirths, placental insufficiency and perinatal death

  • systemic corticosteroids are considered the gold standard in the treatment of IH
    • cyclosporine has been used in steroid resistant cases