Presentación inusual de un penfigoide gestacional

Pemphigoid gestationis (PG) is an autoimmune blistering dermatosis that usually occurs in the second and third trimesters of pregnancy, although onset in the early puerperium is not infrequent. Clinically, this entity consists of pruritic urticarial blisters and vesicles that usually start in the periumbilical area and spread peripherally. PG is associated with prematurity and low birth weight. In 5% of cases, the neonates of mothers with PG may show moderate blistering-vesicular eruptions induced by autoantibodies transferred across the placenta, which usually resolve in a short time. We report the case of a puerperal patient who initially showed acral lesions with a morphology similar to those of exudative erythema multiforme, which subsequently spread to her arms, legs and face resulting in large blisters. Histological studies and direct immunofluorescence were essential to proper diagnosis and subsequent therapeutic management.