Severe nonendemic pemphigus foliaceus presenting in the postpartum period

The new onset of pemphigus in the postpartum period is exceedingly rare wit h only 1 case previously reported in the literature. We describe a 31-year- old woman who developed extensive denudation of her skin shortly after deli vering her second child. Histologic examination, immunofluorescence testing , and immunoprecipitation with desmoglein 1 confirmed the diagnosis of pemp higus foliaceus. The patient responded to treatment with prednisone, cyclop hosphamide, and plasmapheresis. The effect of the postpartum period on the onset and exacerbation of immune-mediated bullous diseases is discussed.