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October 1991

Hypocalcemia in Impetigo Herpetiformis: A Secondary Transient Phenomenon?

Author Affiliations

Department of Dermatology University Hospital Rijnsburgerweg 10 2333 AA Leiden, the Netherlands

Arch Dermatol. 1991;127(10):1587-1588. doi:10.1001/archderm.1991.01680090153027

To the Editor.—  It was with special interest that we read the article by Holm and Goldsmith1 in the January 1991 issue of the Archives. This report suggests the important pathomechanistic role of hypocalcemia in impetigo herpetiformis (IH).

Report of Cases.—  In the past 2 years, IH was diagnosed in two pregnant women who were referred to the Department of Dermatology, University Hospital Leiden (the Netherlands).

CASE 1.—  A 27-year-old, nonpsoriatic woman presented with an acute, itching, erythematous, slightly edematous skin eruption with marginally localized pustules during the 18th week of her second pregnancy. Her first pregnancy resulted in a stillbirth after 11 weeks' gestation. On admission to our hospital, the patient was slightly febrile and moderately ill. Laboratory values at initial screening were as follows: serum calcium level, 1.92 mmol/L (normal, 2.25 to 2.55 mmol/L); albumin, 30 g/L (normal, 40 to 50 g/L); and vitamin D3

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