Is it possible for a pregnant woman to be allergic to the placenta?

Skin irritations can pop up with zero warning, but most of the time are pretty minor in terms of discomfort and are easy enough to treat. PG, however, has been described as causing a severe burning and itching. Zuleika Closs, who experienced PG firsthand told a British daily, "At first, it felt like something was crawling on my skin but then it became unbearable." The physical appearance, as well as the significant discomfort PG causes, can definitely get in the way of day-to-day life, impacting work, as well as family and social interactions [source: Freiman].

The nature of the disease, coupled with its relative rarity, often confuses physicians who've never seen it before, leading to incorrect or delayed diagnoses and treatment. Doctors even told Closs that she had a rampant, contagious case of scabies, which she feared would be passed on to other people, including her baby [source: The Sun]. For the record, PG is not contagious, no matter how severe it looks. Generally, welts appear first, and diagnosis is made easier once the large, raised, fluid-filled blisters appear a couple of weeks later [source: AARDA]. Immunofluorescence, a technique that uses fluorescent dye to locate offending antibodies, helps to determine the level of severity. A dermatologist or an obstetrician typically makes the diagnosis [source: Huilaja et al.].

The disease is a dermatologic condition that usually rears its ugly head during the second or third trimesters (between 13 and 40 weeks), but sometimes appears earlier in pregnancy. Unfortunately, the end date is nearly as nebulous as the onset. Often, symptoms dissipate near the end of pregnancy, but can come roaring back near or during delivery. Even once the child is born, women have been known to experience flare-ups during their menstrual cycles, sometimes years after the fact [source: Freiman]. The use of oral contraceptives can also cause resurgence [source: EADV]. Think of it as the prenatal gift that keeps on giving, except that instead of something awesome like a new smartphone, it's a pair of itchy argyle socks.

Many pregnant women avoid medications at all costs to avoid potential risks to the fetus. The significant pain and discomfort associated with pemphigoid gestationis, however, typically requires some sort of soothing action, keeping the safety of mother and child in mind. Unfortunately, like many other rare diseases, PG treatment has not been studied extensively, and often mirrors the treatment of other dermatologic conditions.

As with many of those, the first line of defense is usually topical (cream) corticosteroids. In mild to moderate cases, this is often enough to placate the PG monster, make it tolerable and keep it from getting worse. Stronger versions are available if the less potent options aren't doing the trick. Oral antihistamines are also often employed to help with the itching. Very severe cases may warrant oral corticosteroid treatment like prednisolone/prednisone, which has a pretty decent safety rating [source: Huilaja et al.]. Less aggressive methods include tepid baths, moisturizers and compresses to relieve itching [source: Freiman].

Although the risk of miscarriage is about the same as normal pregnancies, women dealing with PG are somewhat more likely to experience preterm births, and the babies might be smaller than average. This could be because of "mild placental failure" due to antibodies associated with the disease, or even a reaction to higher-dose steroids used to treat the disease [sources: Huilaja et. al., EADV]. It is possible, but relatively rare (5 to 10 percent of pregnancies), for the baby to wind up with a rash after delivery. Fortunately, the rash usually goes away once the antibodies are eradicated, six weeks or so after birth [source: EADV].

From the mother's perspective, most cases of PG clear up a month or two after delivery, if not sooner, usually with little to no scarring [source: Freiman]. But unfortunately, once she's had the disease she's likely to develop it again in later pregnancies, at a rate of about 90 percent. To add insult to injury, it is more severe and occurs earlier the second time around [source: Lardenoije]. And there is a higher, albeit small, risk of her developing other autoimmune conditions, like Graves' disease. This potential exists for the rest of her life [source: Moore].