Xie et al reported the Pregnancy Dermatoses Clinical Scoring System for distinguishing pemphigoid gestationis from polymorphic eruption of pregnancy. The authors are from the Mayo Clinic, Royal Devon and Exeter NHS Foundation, King's College of Medicine London, University of California San Francisco, University of Zurich, and Hautarzt Practice Graz.
Patient selection: woman during pregnancy or puerperium
Parameters:
(1) previous episode of pemphigoid gestationis
(2) primigravida
(3) week of gestation and onset of rash
(4) umbilical involvement by rash
(5) rash relative to striae
(6) bullae (blisters > 1 cm in diameter)
Parameter
Finding
Points
previous pemphigoid gestationis
no
0
yes
2
primigravida
no
0
yes
-1
onset
before 28 weeks
2
from 28 to 35.9 weeks
1
>= 36 weeks
0
umbilical involvement
no
0
yes
2
rash in striae
no
0
yes
-2
bullae
no
0
yes
2
total score =
= SUM(points for all of the parameters)
Inerpretation:
• minimum score: -3
• maximum score: 8
• A score >= 3 indicates pemphigoid gestationis (PG).
Performance:
• The area under the ROC curve is 0.93.
Additional features from the univariate analysis:
(1) skip pregnancy (condition skipping one or more pregnancies): favors PG
(2) history of multiple testation: against PG
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