Autoimmune Bullous Diseases in Pregnancy

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Autoimmune bullous diseases (AIBDs) are rare organ-specific diseases characterized by the
appearance of blisters and erosions on the skin and mucous membranes. These
dermatoses are marked by the development of autoantibodies targeting the autoantigens
located in intercellular junctions, i.e., between keratinocytes or in the basement membrane
area. Therefore, the fundamental division of AIBDs into the pemphigus and pemphigoid
groups exists. Although AIBDs are uncommon in the general population, their overall
incidence is somewhat higher in women of all ages, for which a pregnant women can be
likely affected too. While the pemphigoid gestationis is exclusive bullous dermatosis of
pregnancy, the other AIBDs can also start or worsen during this period. The appearance of
AIBDs in childbearing women is a particularly sensitive situation requiring exceptional
clinicians’ caution due to the possibility of pregnancy complications with adverse effects and
risks to the mother and the child. Also, there are numerous management difficulties in the
period of pregnancy and lactation related to the drugs’ choice and safety.