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H. Bing Thio, MD; Bert Jan Vermeer, MD, PhD
Department of Dermatology University Hospital Rijnsburgerweg 10 2333 AA Leiden, the Netherlands

Arch Dermatol. 1991;127(10):1587-1588.

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To the Editor.—

It was with special interest that we read the article by Holm and Goldsmith¹ in the January 1991 issue of the ARCHIVES. This report suggests the important pathomechanistic role of hypocalcemia in impetigo herpetiformis (IH).

Report of Cases.—

In the past 2 years, IH was diagnosed in two pregnant women who were referred to the Department of Dermatology, University Hospital Leiden (the Netherlands).

CASE 1.—

A 27-year-old, nonpsoriatic woman presented with an acute, itching, erythematous, slightly edematous skin eruption with marginally localized pustules during the 18th week of her second pregnancy. Her first pregnancy resulted in a stillbirth after 11 weeks' gestation. On admission to our hospital, the patient was slightly febrile and moderately ill. Laboratory values at initial screening were as follows: serum calcium level, 1.92 mmol/L (normal, 2.25 to 2.55 mmol/L); albumin, 30 g/L (normal, 40 to 50 g/L); and vitamin D₃ . . . [Full Text PDF of this Article]

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