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September 1995

An Uninvolved Pregnancy in a Patient After a Previous Episode of Herpes Gestationis

Author Affiliations

Department of Dermatology Royal Victoria Infirmary Queen Victoria Road Newcastle Upon Tyne, England NE1 4LP

Arch Dermatol. 1995;131(9):1091-1092. doi:10.1001/archderm.1995.01690210123027

Herpes gestationis is a blistering disease associated with pregnancy that almost invariably recurs in subsequent pregnancies.1,2 Immunologic factors have been implicated in the pathogenesis of herpes gestationis, and women with HLA-DR3 and -DR4 antigens are most at risk.3,4 Uninvolved pregnancies have been described and were thought to occur in association with a change in paternity.3 It has been suggested that an uninvolved pregnancy may occur if the fetus has the HLA-DR antigens possessed by the mother.1 We describe a patient whose first pregnancy was complicated by herpes gestationis but whose second was not, despite constant paternity and nonmatching HLA-DR antigens between mother and child.

Report of a Case.  A 27-year-old woman presented during the 16th week of her first pregnancy with a 4-week history of a pruritic periumbilical rash. Her pregnancy was otherwise uncomplicated. At presentation, tense blisters arising on urticated erythema were seen on the