Clinical manifestation

Eruption develops during the second and third trimesters; in 25% of patients, lesions appear immediately after delivery, begin as intensely pruritic erythematous urticarial patches and plaques, often periumbilical; lesions progress to tense vesicles and bul-lae, spreading peripherally, often sparing the face, palms, soles, and mucous membranes; disease activity usually remits within days after parturition; some patients have persistent disease activity that lasts months or years; sometimes recurs with the resumption of menses, use of oral contraceptives, and with subsequent pregnancies

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