PG is exclusively associated with pregnancy. It typically presents during late pregnancy with the abrupt onset of intensely pruritic urticarial lesions. Fifty percent of patients experience first onset on the abdomen, often within or immediately adjacent to the umbilicus. The other half present with typical lesions, but in an atypical distribution (extremities, palms, or soles). Rapid progression to a generalized, pemphigoid-like eruption, sparing only the face, mucous membranes, palms, and soles is the rule (although any site may be involved). Flares occur with delivery in approximately 75% of patients and may be dramatic. The explosive onset of blistering may occur within hours of delivery, either as a flare of preexisting disease or as presentation de novo. Up to one-quarter of patients initially present during the immediate postpartum period.