Introduction: We describe a patient who developed an acute generalised pustular eruption associated with pyrexia at 33 weeks of gestation. Clinical Picture: Her condition was complicated by preterm labour, requiring an emergency caesarean section delivery. A diagnosis of impetigo herpetiformis was made on clinicopathological grounds. Treatment: Initial treatment with topical and systemic corticosteroids failed and oral methotrexate was added. Outcome: She responded well to this therapy and required only 2 doses of weekly methotrexate. Conclusion: Impetigo herpetiformis is a rare dermatosis of pregnancy that requires early recognition and treatment to prevent maternal and fetal morbidity. Combination therapy using oral corticosteroids and short-term methotrexate is effective.
Impetigo herpetiformis (IH) is a rare dermatosis of pregnancy that can present dramatically in the third trimester of pregnancy with widespread cutaneous pustulosis and serious systemic features, including fetal distress.1,2 Early recognition of this condition is of utmost importance as maternal and fetal well-being may be compromised due to misdiagnosis and inappropriate treatment. This condition is often confused with other diagnoses such as pustular drug eruptions or bacterial skin sepsis. Clinicopathological correlation is essential for the diagnosis of this condition.
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