Psoriasis – Impetigo Herpetiformis

Impetigo Herpetiformis is a term for Pustular Psoriasis of Pregnancy and I occasionally encounter this form of Psoriasis in both my The Woodlands dermatology and Conroe dermatology offices.  Impetigo Herpetiformis usually occurs in the 3rd trimester and is usually seen in women with no prior history and no family history of Psoriasis.  Essentially, the pregnancy is the trigger for the development of Impetigo Herpetiformis.  The lesions usually begin as flaccid pustules on a red plaque in the groin and can quickly spread to the rest of the body.  As in Pustular Psoriasis, severe systemic effects can occur such as changes in the body’s homeostasis and hypocalcemia. Many patients are admitted to the hospital for supportive care and close observation.  Some patients are treated with systemic steroids.  Impetigo Herpetiformis does not usually resolve until the patient gives birth.  The fetus is at risk for still birth and placental insufficiency.  Patients with Impetigo Herpetiformis are also at risk for the recurrence of this disease with subsequent pregnancies.