Impetigo Herpetiformis in a Primigravida: Successful Treatment with Etretinate

Impetigo herpetiformis (IH) is a rare dermatosis which usually occurs during the third trimester of pregnancy. It is characterized by acute erythematosquamous plaques covered with tiny superficial pustules in a herpetiform distribution with less likely mucus membranes involvement1. It can be associated with constitutional symptom s such as fever, chills, nausea, vomiting and diarrhea2-4. Impetigo herpetiformis can cause serious complications to the mother and fetus which include: maternal hypocalcemia leading to delirium, convulsions, and tetany in the mother2,5, and placental insufficiency leading to still birth, neonatal death or fetal abnormalities1,4,6,7. Lesions are expected to disappear after birth but may recur during subsequent pregnancies at an earlier gestational age8,9. Presented here is a case of IH occurring during the 37th week of gestation in a primigravida who failed to respond to oral steroid but successfully cleared with oral etretinate.