A Case Report: High Dose Systemic Corticosteroids as the Therapy for Severe Case Impetigo Herpetiformis

Introduction: Impetigo herpetiformis (IH) is a rare but life-threatening dermatosis of pregnancy. Early recognition and treatment of IH is important because it may cause maternal and fetal morbidity and mortality. Systemic corticosteroids remain the mainstay of treatment for IH and are considered safe for pregnancy. The purpose of this study was to present successful high-dose corticosteroids as a therapy for severe cases of IH. Case: We reported a 34-year-old pregnant woman in third trimester of pregnancy with a two-week history of reddish patches and pustules spread almost all over her body. She had a history of the same complaint in her latest pregnancy. The diagnosis of severe IH was made based on clinical, laboratory, and histopathology findings. She was prescribed 80 mg/day of oral prednisolone. The eruption and systemic symptoms gradually improved after 12 weeks of treatment. The dose was maintained until delivery before tapered gradually and stopped. The baby was born healthy, and there were not any new lesions. Discussion: Given the possibility of fetal and maternal complications that are potentially lifethreatening, IH needs to be detected and treated right away. The mainstay of treatment for IH is systemic corticosteroids. Steroids control the eruption by preventing polymorphonuclear cells from migrating. Due to its limited placental transmission, prednisolone is regarded to be safe for uses during pregnancy. After 12 weeks of treatment of 80 mg daily prednisolone, the eruptions were resolved and there were not any side effects of steroid observed in both the mother and the baby. Conclusion: Impetigo herpetiformis not only needs early treatment to prevent maternal and fetal complications but also the safety of the treatment chosen. High-dose oral prednisolone is considered effective and safe to control a severe case of IH as it has low placental transmission.