Management of Pemphigus Vulgaris in Pregnancy - Case Report

Pemphigus vulgaris is a rare autoimmune bullous disease caused by producing autoantibodies directed againsttransmembrane glycoproteins of desmosomes that can lead to steric hindrance to homophilic adhesion ofdesmogleins. The development of pemphigus during the pregnancy is rare. The disruption of the Th1:Th2 balancein the autoimmune disease during the pregnancy plays a crucial role and explains why some studies have reportedthe exacerbation of disease, while others observe improvements during the pregnancy. We present aclinical case ofa 31-year-oldprimigravida, with dichorionic - diamniotic twin pregnancyassociatedwith pemphigus vulgaris, beingdiscovered 2 years ago, who went under treatment with Medrol 64mg/day and Imuran 50mg/day. She was admittedto the hospital at 31 weeks of gestation with non-systemic contractions of moderate intensity. The clinical findingsare multiple erosions and blisters which have been accentuated during the second semester and have been remittedafter delivery. Nowadays, the therapeutic management of the pemphigus during the pregnancy is not yet establishedand all of these cases are individual evaluated with the primary target to control the disease with the safety of thefetus.