Bullous impetigo and pregnancy: Case report and review of blistering conditions in pregnancy

Abstract

Background: Bullous impetigo results from Staphylococcus aureus (S. aureus) release of exfoliative toxins type A and type B that results in flaccid, easily ruptured, bullae in the upper layers of the epidermis. Physiologic, gestation-associated, and incidental skin changes can occur in pregnancy. Blisters in pregnant women can occur secondary to either common skin disorders or specific dermatoses of pregnancy. Purpose: To describe a pregnant woman with bullous impetigo and review bullous conditions in pregnant women. Methods: PubMed was used to search the following terms, separately and in combination: blister, blistering, bullous, gestationis, herpes, herpetiformis, impetigo, pemphigoid, pregnancy, pregnant, psoriasis, pustular, virus. All papers were reviewed and relevant manuscripts, along with their reference citations, were evaluated. Results: Flaccid, easily rupturing, pustules, which developed into superficial annular erosions with peripheral scale and central healing appeared in a woman of 7-weeks gestation and allergy to penicillin on her lower abdomen, suprapubic region, perineum, buttocks, and proximal legs. A bacterial culture subsequently isolated methicillin-susceptible S. aureus. All of the lesions resolved after treatment with clindamycin. Conclusions: Bullous impetigo should be considered in the differential diagnosis of common skin diseases presenting as blisters in pregnant women.