From prurigo gestationis Besnier to atopic eruption of pregnancy: the confusing nosology of the less well-defined dermatoses of pregnancy has been largely clarified

Abstract Background: Dermatoses of pregnancy (DP) is a heterogeneous group of pruritic inflammatory dermatoses that occur exclusively during pregnancy and/or puerperium. The objective of this study was to assess the specific DP and non-specific dermatoses in a Mediterranean population living in Spain. Methods: This five-year retrospective study included 79 pregnant women with dermatologic disease from a total of 10533 pregnancies. Obstetric and clinical variables were assessed. Physiological skin changes of pregnancy were excluded. Those dermatoses that may also be observed beyond pregnancy and puerperium were also excluded. Results: The mean age was 32 years. The most common DP were: Polymorphic eruption of pregnancy (PEP) – 36%, Atopic eruption of pregnancy (AEP) – 26%, Intrahepatic cholestasis of pregnancy (ICP) – 8% and Pemphigoid gestationis (PG) – 6%. The other 24% presented non-specific dermatoses. Only in one case of PG the newborn showed comorbidity. Discussion: Multiple gestations were observed in 10,3% of PEP, in association with a rapid abdominal distention. In AEP, there was a predominance of nulliparous women in the second trimester of pregnancy, an atopic dermatitis background and female newborns. In PG, there was a majority of nulliparous in the second and third trimesters. PG was the only dermatoses associated to comorbidity of the newborn. In ICP, all patients had pruritus in the palms along with excoriations, with predominance of nulliparous and multiple gestations.

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Dermatological Diseases Associated with Pregnancy: Pemphigoid Gestationis, Polymorphic Eruption of Pregnancy, Intrahepatic Cholestasis of Pregnancy, and Atopic Eruption of Pregnancy

Dermatology Research and Practice ◽

10.1155/2015/979635 ◽

2015 ◽

Vol 2015 ◽

pp. 1-7 ◽

Cited By ~ 4

Author(s):

Christine Sävervall ◽

Freja Lærke Sand ◽

Simon Francis Thomsen

Keyword(s):

Intrahepatic Cholestasis ◽

Clinical Importance ◽

Intrahepatic Cholestasis Of Pregnancy ◽

Pemphigoid Gestationis ◽

Polymorphic Eruption Of Pregnancy ◽

Atopic Eruption Of Pregnancy ◽

Considerable Morbidity ◽

Dermatoses Of Pregnancy ◽

Cholestasis Of Pregnancy ◽

Pregnant Mothers

Dermatoses unique to pregnancy are important to recognize for the clinician as they carry considerable morbidity for pregnant mothers and in some instances constitute a risk to the fetus. These diseases include pemphigoid gestationis, polymorphic eruption of pregnancy, intrahepatic cholestasis of pregnancy, and atopic eruption of pregnancy. This review discusses the pathogenesis, clinical importance, and management of the dermatoses of pregnancy.

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Specific dermatoses of pregnancy: New classification and differential diagnosis

Medicinski pregled ◽

10.2298/mpns0812586m ◽

2008 ◽

Vol 61 (11-12) ◽

pp. 586-590 ◽

Cited By ~ 1

Author(s):

Ljiljana Medenica ◽

Sonja Vesic ◽

Jelica Sretenovic-Vukicevic

Keyword(s):

Intrahepatic Cholestasis ◽

Elevated Serum ◽

Direct Immunofluorescence ◽

Intrahepatic Cholestasis Of Pregnancy ◽

Pemphigoid Gestationis ◽

Polymorphic Eruption Of Pregnancy ◽

Atopic Eruption Of Pregnancy ◽

Maternal Quality Of Life ◽

Dermatoses Of Pregnancy ◽

Cholestasis Of Pregnancy

Introduction The specific dermatoses of pregnancy represent heterogeneous group of pruritic skin disorders that occur exclusively in pregnancy. Specific Dermatoses of pregnancy The updated classification proposed subdividing specific dermatoses of pregnancy into four main categories: 1. atopic eruption of pregnancy; 2. polymorphic eruption of pregnancy; 3. pemphigoid gestationis; 4. intrahepatic cholestasis of pregnancy. Severe pruritius, which is the main symptom in all 4 entities, can impair maternal quality of life. Significant maternal risks are not associated with specific dermatoses of pregnancy; however, pemphigoid gestationis and intrahepatic cholestasis of pregnancy are associated with fetal risks. Conclusion Pathognomonic laboratory tests are not available, except direct immunofluorescence which is diagnostic of pemphigoid gestationis and elevated serum level of bile acids of intrahepatic cholestasis of pregnancy. Characteristic clinical features provide discrimination between polymorphic eruption of pregnancy and atopic eruption of pregnancy.

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The skin in pregnancy

Oxford Textbook of Medicine ◽

10.1093/med/9780198746690.003.0275 ◽

2020 ◽

pp. 2648-2654

Author(s):

Gudula Kirtschig ◽

Fenella Wojnarowska

Keyword(s):

Basement Membrane Zone ◽

Topical Steroids ◽

Atopic Eruption Of Pregnancy ◽

Mother And Child ◽

Trunk Limbs ◽

Circulating Antibodies ◽

Hands And Feet ◽

Dermatoses Of Pregnancy ◽

Cholestasis Of Pregnancy ◽

In Pregnancy

Dermatoses in pregnancy are common, they may be very itchy and may influence the life of a pregnant woman dramatically. There are four classical dermatoses of pregnancy, which this chapter will examine. It is particularly important to recognize these as they may have serious health implications for mother and child. Intrahepatic cholestasis of pregnancy occurs in 1/40 to 1/500 pregnancies and is the most serious cause of itch in pregnancy, with potentially substantial effects on mother and fetus. Meanwhile, atopic eruption of pregnancy affects 1/300 pregnancies, typically with an eczematous eruption over abdomen and limbs. Pemphigoid gestationis occurs in 1/50,000 pregnancies and is due to circulating antibodies against the skin basement membrane zone. The eruption often begins around the umbilicus and spreads to the whole trunk, limbs, hands, and feet. If potent topical steroids fail systemic steroids are required. Transplacental transmission to the fetus may also occur. Recurrence in future pregnancies is to be expected.

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