Pemphigoid gestationis is an autoimmune bullous eruption specific to pregnancy. It usually presents in the second or third trimester and is characterized by postpartum exacerbations of the disease. Most cases resolve within a few months of delivery, but the disease may be more persistent, developing characteristics of bullous pemphigoid which can be difficult to treat. We now report a patient with severe pemphigoid gestationis, in whom the disease has persisted for 1.5 years postpartum and who developed features more typical of bullous pemphigoid. We discuss this phenomenon and the management of such cases.