Dermatological Disorders Associated with Pregnancy
DOI:
https://doi.org/10.12775/JEHS.2025.78.57422Keywords
pregnancy dermatoses, pemphigoid gestationis, polymorphic eruption of pregnancy, intrahepatic cholestasis of pregnancy, pustular psoriasis of pregnancy, atopic eruption of pregnancyAbstract
Introduction and purpose: Pregnancy is a remarkable and delicate period in a woman's life, marked by significant physiological adaptations to accommodate the growing fetus. These changes affect every organ system, including the skin. The aim of this review paper is to raise awareness and assist clinicians in recognizing, diagnosing, and effectively managing these distinct skin conditions associated with pregnancy.
Material and methods: An extensive examination of articles published in scientific journals was carried out through online research platforms PubMed and Google Scholar. We searched articles by entering keywords in appropriate configuration: “pregnancy dermatoses”, “pemphigoid gestationis”, “ polymorphic eruption of pregnancy”, “intrahepatic cholestasis of pregnancy”, “pustular psoriasis of pregnancy”, “atopic eruption of pregnancy”.
Description of the state of knowledge: This diverse set of pregnancy-related skin conditions includes pemphigoid gestationis, polymorphic eruption of pregnancy, intrahepatic cholestasis of pregnancy, atopic eruption of pregnancy, and pustular psoriasis of pregnancy.
Summary: Early diagnosis and treatment are crucial to mitigate maternal and fetal complications, and in some conditions, prevent fatalities. Improving clinicians' in-depth understanding of these disease processes can enhance patient safety and quality of life during and after pregnancy.
References
[1] “Soutou B, Aractingi S. Skin disease in pregnancy. Best Pract Res Clin Obstet Gynaecol. 2015 Jul;29(5):732-40.,”
[2] C. C. Motosko, A. K. Bieber, M. K. Pomeranz, J. Stein, and K. J. Martires, “Physiologic changes of pregnancy: A review of the literature,” International Journal of Women’s Dermatology, vol. 3, no. 4. Lippincott Williams & Wilkins, p. 219, Oct. 23, 2017. doi: 10.1016/j.ijwd.2017.09.003.
[3] P. Soma‐Pillay, C. Nelson‐Piercy, H. Tolppanen, and A. Mebazaa, “Physiological changes in pregnancy,” Cardiovascular journal of South Africa/Cardiovascular journal of Southern Africa, vol. 27, no. 2. Clinics Cardive Publishing, p. 89, May 18, 2016. doi: 10.5830/cvja-2016-021.
[4] “Maglie R, Quintarelli L, Verdelli A, Fabbri P, Antiga E, Caproni M. Specific dermatoses of pregnancy other than pemphigoid gestationis. G Ital Dermatol Venereol. 2019 Jun;154(3):286-298.,”
[5] “Himeles JR, Pomeranz MK. Recognizing, Diagnosing, and Managing Pregnancy Dermatoses. Obstet Gynecol. 2022 Oct 01;140(4):679-695.,”
[6] “Jenkins R.E., Hern S., Black M.M.: Clinical features and management of 87 patients with pemphigoid gestationis. Clin. Exp. Dermatol., 1999; 24: 255-259. DOI: 10.1046/j.1365-2230.1999.00472.x,”
[7] “Semkova K., Black M.: Pemphigoid gestationis: current insights into pathogenesis and treatment. Eur. J. Obstet. Gynecol. Reprod. Biol., 2009; 145: 138-44. DOI: 10.1016/j.ejogrb.2009.05.012,”
[8] “Beard M.P., Millington G.W.M.: Recent developments in the specific dermatoses of pregnancy. Clin. Exp. Dermatol., 2012; 37: 1-4. DOI: 10.1111/j.1365-2230.2011.04173.x,”
[9] “ Kroumpouzos G., Cohen L.M.: Specific dermatoses of pregnancy: an evidence-based systematic review. J. Am. Acad. Dermatol., 2003; 188: 1083-1092. DOI: 10.1067/mob.2003.129,”
[10] “ Sävervall C., Sand F.L., Thomsen S.F.: Pemphigoid gestationis: current perspectives. Clin. Cosmet. Investig. Dermatol., 2017; 10: 441-449. DOI: 10.2147/ccid.S128144,”
[11] “Al-Saif F., Elisa A., Al-Homidy A. i wsp.: Retrospective analysis of pemphigoid gestationis in 32 Saudi patients - clinicopathological features and a literature review. J. Reprod. Immunol., 2016; 116: 42-45. DOI: 10.1016/j.jri.2016.04.286.10,”
[12] “ Intong L.R.A., Murrell D.F.: Pemphigoid gestationis: pathogenesis and clinical features. Dermatol. Clin., 2011; 29: 447-452, ix. ix. DOI: 10.1016/j.det.2011.03.002,”
[13] “Lehrhoff S., Pomeranz M.K.: Specific dermatoses of pregnancy and their treatment. Dermatol. Ther., 2013; 26: 274-284. DOI: 10.1111/dth.12078,”
[14] “Powell A.M., Sakuma-Oyama Y., Oyama N. i wsp.: Usefulness of BP180 NC16a enzyme-linked immunosorbent assay in the serodiagnosis of pemphigoid gestationis and in differentiating between pemphigoid gestationis and pruritic urticarial papules and plaques of pregnancy. Arch. Dermatol., 2005; 141: 705-710. DOI: 10.1001/archderm.141.6.705,”
[15] “Kushner C.J., Concha J.S.S., Werth V.P.: Treatment of autoimmune bullous disorders in pregnancy. Am. J. Clin. Dermatol., 2018; 19: 391-403. DOI: 10.1007/s40257-018-0342-0,”
[16] “Diav-Citrin O., Shechtman S., Aharonovich A. i wsp.: Pregnancy outcome after gestational exposure to loratadine or antihistamines: a prospective controlled cohort study. J. Allergy Clin. Immunol., 2003; 111: 1239-1243. DOI: 10.1067/mai.2003.1499,”
[17] “Rudolph C.M., Al-Fares S., Vaughan-Jones S.A. i wsp.: Polymorphic eruption of pregnancy: clinicopathology and potential trigger factors in 181 patients. Br. J. Dermatol., 2006; 154: 54-60. DOI: 10.1111/j.1365-2133.2005.06856.x,”
[18] “Gänshirt D., Garritsen H.S., Holzgreve W.: Fetal cells in maternal blood. Curr. Opin. Obstet. Gynecol., 1995; 7: 103-108. DOI: 10.1097/00001703-199504000-00005,”
[19] “Dominguez-Serrano AJ, Quiroga-Garza A, Jacobo-Baca G, De La Fuente-Villarreal D, Gonzalez-Ramirez RA, Vazquez-Barragan MA, Guzman-Lopez A, Elizondo-Omaña RE, Guzman-Lopez S. Polymorphic eruption of pregnancy in Mexico. Int J Dermatol. 2019 Mar;58(3):259-262.,”
[20] “Mashburn S, Schleckman E, Cackovic P, Shellhaas C, Rood KM, Ma’ayeh M. Intrahepatic cholestasis of pregnancy: risk factors for severe disease. J Matern Fetal Neonatal Med. 2022 Dec;35(25):8566-8570.,”
[21] “Geenes V., Williamson C.: Intrahepatic cholestasis of pregnancy. World J. Gastroenterol., 2009; 15: 2049-2066. DOI: 10.3748/wjg.15.2049,”
[22] “ Williamson C., Geenes V.: Intrahepatic cholestasis of pregnancy. Obstet. Gynecol., 2014; 124: 120-133. DOI: 10.1097/aog.0000000000000346,”
[23] “Kenyon A.P., Piercy C.N., Girling J. i wsp.: Obstetric cholestasis, outcome with active management: a series of 70 cases. BJOG, 2002; 109: 282-288. DOI: 10.1111/j.1471-0528.2002.01368.x,”
[24] “Ambros-Rudolph C.M.: Dermatoses of pregnancy - clues to diagnosis, fetal risk and therapy. Ann. Dermatol., 2011; 23: 265-275. DOI: 10.5021/ad.2011.23.3.265,”
[25] “Manzotti C., Casazza G., Stimac T. i wsp.: Total serum bile acids or serum bile acid profile, or both, for the diagnosis of intrahepatic cholestasis of pregnancy. The Cochrane Database of Systematic Reviews, 2019, Issue 7. Art. No.: CD012546. DOI: ,”
[26] “ Chappell L.C., Gurung V., Seed P.T. i wsp.: Ursodeoxycholic acid versus placebo, and early term delivery versus expectant management, in women with intrahepatic cholestasis of pregnancy: semifactorial randomised clinical trial. BMJ, 2012; 344: e3799. DOI: 10.1136/bmj.e3799,”
[27] “Brites D., Rodrigues C.M., Oliveira N. i wsp.: Correction of maternal serum bile acid profile during ursodeoxycholic acid therapy in cholestasis of pregnancy. J. Hepatol., 1998; 28: 91-98. DOI: 10.1016/s0168-8278(98)80207-9,”
[28] “Society for Maternal-Fetal Medicine; Mara Greenberg, Metz T.D., Pettker C.M.: Society for Maternal-Fetal Medicine consult series #53: intrahepatic cholestasis of pregnancy: replaces consult #13, April 2011. J. Am. Acad. Dermatol., 2021; 224: B2-B9. DOI: 10.1016/j.ajog.2020.11.002,”
[29] “Kroumpouzos G, Cohen LM. Dermatoses of pregnancy. J Am Acad Dermatol. 2001;45:1-19.,”
[30] “Ambros-Rudolph C.M., Mullegger R.R., Vaughan-Jones S.A. i wsp.: The specific dermatoses of pregnancy revisited and reclassified: results of a retrospective two-center study on 505 pregnant patients. J. Am. Acad. Dermatol., 2006; 54: 395-404. DOI: 10.1016/j.jaad.2005.12.012,”
[31] “Vaughan Jones S.A., Hern S., Nelson-Piercy C. i wsp.: A prospective study of 200 women with dermatoses of pregnancy correlating clinical findings with hormonal and immunopathological profiles. Br. J. Dermatol., 1999; 141: 71-81. DOI: 10.1046/j.1365-2133.1999.02923.x,”
[32] “Roth M.M., Cristodor P., Kroumpouzos G.: Prurigo, pruritic folliculitis, and atopic eruption of pregnancy: facts and controversies. Clin. Dermatol., 2016; 34: 392-400. DOI: 10.1016/j.clindermatol.2016.02.012,”
[33] “Sasseville D., Wilkinson R.D., Schnader J.Y.: Dermatoses of pregnancy. Int. J. Dermatol., 1981; 20: 223-241. DOI: 10.1111/j.1365-4362.1981.tb04327.x,”
[34] “Cravo M., Vieira R., Tellechea O., Figueiredo A.: Recurrent impetigo herpetiformis successfully treated with methotrexate. J. Eur. Acad. Dermatol. Venereol., 2009; 23: 336-337. DOI: 10.1111/j.1468-3083.2008.02867.x,”
[35] “Namazi N., Dadkhahfar S.: Impetigo herpetiformis: review of pathogenesis, complication, and treatment. Dermatol. Res. Pract., 2018. DOI: 10.1155/2018/5801280. 5 801280,”
[36] “Wamalwa E.W.: Recurrent impetigo herpetiformis: case report. Pan. Afr. Med. J., 2017; 27: 219. DOI: 10.11604/pamj.2017.27.219.12826,”
[37] F. Zéglaoui, A. Khaled, B. Fazaa, O. Riahi, R. Zermani, and M. Kamoun, “Multiple subepidermal calcified nodules on the eyelids with eruptive syringomas: a possible ethiopathogenic relationship,” Journal of the European Academy of Dermatology and Venereology, vol. 23, no. 3, Wiley, p. 337, Jun. 11, 2008. doi: 10.1111/j.1468-3083.2008.02870.x.
[38] “Yang C.S., Teeple M., Muglia J., Robinson-Bostom L.: Inflammatory and glandular skin disease in pregnancy. Clin. Dermatol., 2016; 34: 335-343. DOI: 10.1016/j.clindermatol.2016.02.005,”
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Grzegorz Szcześniak, Aleksandra Kiełczewska, Anna Kiełczewska
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0
Stats
Number of views and downloads: 157
Number of citations: 0
