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Dermatoses of Pregnancy

Specific Dermatoses of Pregnancy

»Name four pregnancy-specific dermatological disorders
»What is pruritic urticarial papules and plaques of pregnancy?
»Does PUPPP have any associated morbidity?
»How is PUPPP treated?
»From which dermatosis of pregnancy must PUPPP be differentiated?
»What is pemphigoid gestationis?
»What are the antigens associated with the development on pemphigoid gestationis?
»Which histocompatibility leukocyte antigen (HLA) types have been associated with pemphigoid gestationis?
»Compare PUPPP and pemphigoid gestationis.
»What is atopic eruption of pregnancy?
»What is intrahepatic cholestasis of pregnancy?
»What is the epidemiology of ICP?
»Are there specific laboratory findings to establish the diagnosis?
»What risks and outcomes are associated with intrahepatic cholestasis of pregnancy?
»How is cholestasis of pregnancy treated?
»Is impetigo herpetiformis a distinct clinical disease?
»Are there lab findings associated with impetigo herpetiformis?
»What is the treatment for impetigo herpetiformis?

Physiologic Skin Changes in Pregnancy

»List the physiologic skin changes that can occur as a normal part of pregnancy.
»What are some of the normal pigmentary changes that can be associated with pregnancy?
»Why do these pigmentary changes occur?
»How does pregnancy affect patients with melanoma?
»Is pregnancy associated with changes in hair growth?
»List the vascular changes that can occur in pregnancy.
»What factors influence the development of striae distensae (commonly known as “stretch marks”)?
»Discuss two cutaneous tumors often associated with pregnancy.
»Do some diseases improve with pregnancy?
»Do some mucocutaneous diseases worsen in pregnancy?

 
 
 

What is atopic eruption of pregnancy?

Atopic eruption of pregnancy is classified to include eczema of pregnancy, prurigo gestationis, and folliculitis of pregnancy. According to the retrospective study by Ambros-Rudolph et al, it is the most common dermatoses of pregnancy, with a prevalence of 50.7%. In this study 20% of the patients were known to have preexisting atopic dermatitis, but 80% of the patients reviewed experienced symptoms de novo during pregnancy. It is known to start early in pregnancy, before the third trimester. The skin lesions are erythematous, excoriated papules, plaques, or nodules on the extensor surfaces of the limbs and on the trunk, and may appear crusted and eczematous. The treatment involves topical corticosteroids, and the disease usually resolves in the postpartum period.

Ambros-Rudolph CM, Müllegger RR, Vaughan-Jones SA, et al: The specific dermatoses of pregnancy revisited and reclassified: results of a retrospective two-center study on 505 pregnant patients, J Am Acad Dermatol 54(3):395–404, 2006.