Chronic Herpes Gestationis

A34-year-old woman (gravida 3, para 2) presented at 28 weeks’ gestation with a 3-week history of a pruritic rash that had progressively worsened. Multiple vesicles and bullae were noted; erosions and crusts on older lesions were also present. The patient had had no prodromal symptoms; she denied fever, chills, nausea, and vomiting. The purplish hue on her body resulted from application of the topical antibacterial agent, gentian violet, which the patient had obtained in Mexico. Dr Azin Meshkinpour of Irvine, Calif, writes that the patient had a similar rash during each of her previous pregnancies; these eruptions had resolved a few weeks after delivery. However, this outbreak was far worse than previous episodes. A clinical diagnosis of herpes gestationis was made. The patient could not remember the topical agents she had used during her 2 previous pregnancies. Despite the mother’s rash at delivery, both neonates were born without skin problems after uncomplicated labors. Prednisone was considered for the patient; however, she was lost to follow-up before the drug could be prescribed.