Abstract: The treatment of impetigo herpetiformis (IH) during pregnancy remains a challenge and the main difficulty in treatment lies in the limitations of the medications used in pregnancy. Glucocorticoids and cyclosporine are the recommended first-line regimens for the treatment of IH. Biologics may be used cautiously when other drugs are ineffective. It has been reported that IH was successfully treated with TNF-α in the previous literature reports. In this paper, two cases of IH were treated with TNF-α antagonists when conventional treatment failed. Both patients' skin lesions were controlled before delivery, and healthy neonates were delivered, which provided a reference for the treatment of IH. However, more cases are needed for a safer and more systematic treatment plan.

Key words: impetigo herpetiformis, IL-36RN, TNF-α inhibitors