Recurrent pemphigoid gestationis in the setting of first-trimester spontaneous abortions

Pemphigoid gestationis (PG) is a rare, autoimmune subepidermal blistering disease, occurring in approximately 1 in 50,000 pregnancies.1 In this disease, abnormal expression of major histocompatibility complex class II antigens in the placenta stimulates maternal antibody production, which bind to the BP180/230 antigens in the placenta and cross react with BP180/230 antigens in the basement membrane of the skin. This results in activation of the inflammatory complement cascade, causing subepidermal blister formation.