Dermatoses of pregnancy: pemphigoid gestationis: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

OBG · Dermatoses of pregnancy: pemphigoid gestationis

Sample item

A 27-year-old at 30 weeks has intensely pruritic urticarial plaques starting around the umbilicus that progress to tense vesicles and bullae. Direct immunofluorescence shows linear C3 deposition at the basement membrane. What is the diagnosis and risk?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Pemphigoid gestationis, with increased risk of preterm birth and small-for-gestational-age infants

Pemphigoid gestationis is an autoimmune blistering disorder against the BP180 antigen, typically beginning periumbilically in the second or third trimester. It tends to recur in later pregnancies and is associated with prematurity and growth restriction. Treatment is with topical or oral corticosteroids.

Option by option

  • A. Impetigo herpetiformis

    Impetigo herpetiformis is pustular and associated with hypocalcaemia.

  • B. Intrahepatic cholestasis of pregnancy

    Cholestasis causes itching without a primary rash.

  • C. PUPPP, which spares the umbilicus

    PUPPP spares the umbilicus and does not form bullae with linear C3 deposition.

  • D. Pemphigoid gestationis, with increased risk of preterm birth and small-for-gestational-age infants (correct)

    Correct. Periumbilical bullae with linear C3 on immunofluorescence point to pemphigoid gestationis.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More OBG questions

Questions about this OBG question

What is the answer to this OBG question?

The best answer is D, Pemphigoid gestationis, with increased risk of preterm birth and small-for-gestational-age infants. Pemphigoid gestationis is an autoimmune blistering disorder against the BP180 antigen, typically beginning periumbilically in the second or third trimester.

Why is "Impetigo herpetiformis" not the answer?

Impetigo herpetiformis is pustular and associated with hypocalcaemia.

Why is "Intrahepatic cholestasis of pregnancy" not the answer?

Cholestasis causes itching without a primary rash.

Why is "PUPPP, which spares the umbilicus" not the answer?

PUPPP spares the umbilicus and does not form bullae with linear C3 deposition.

What concept does this question test?

It tests Dermatoses of pregnancy: pemphigoid gestationis in OBG. It tends to recur in later pregnancies and is associated with prematurity and growth restriction. Treatment is with topical or oral corticosteroids.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Dermatoses of pregnancy: pemphigoid gestationis?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.