The Specific Dermatoses of Pregnancy
DOI:
https://doi.org/10.12775/QS.2024.38.58219Keywords
pregnancy-specific dermatoses, atopic eruption of pregnancy, polymorphic eruption of pregnancy, intrahepatic cholestasis of pregnancy, pemphigoid gestationisAbstract
Introduction and purpose: Pregnancy-specific dermatoses are a group of pruritic skin disorders that arise exclusively during pregnancy or the postpartum period. They encompass four primary conditions: atopic eruption of pregnancy (AEP), polymorphic eruption of pregnancy (PEP), intrahepatic cholestasis of pregnancy (ICP), and pemphigoid gestationis (PG). This review aims to provide a comprehensive analysis of their prevalence, clinical characteristics, underlying mechanisms, therapeutic strategies, and potential fetal risks.
Results: These dermatoses often present with overlapping clinical features, making accurate differential diagnosis crucial. While some pose minimal risk to the fetus, others, such as ICP and PG, are associated with significant complications, including preterm birth and stillbirth. The underlying pathophysiology remains incompletely understood, with hormonal, immunological, genetic, and environmental factors playing key roles. Treatment strategies focus primarily on symptomatic relief, with topical corticosteroids and oral antihistamines being the mainstay of therapy, while ursodeoxycholic acid is the treatment of choice for ICP.
Conclusions: A multidisciplinary approach is essential for optimal maternal and fetal outcomes. Further research is needed to better understand the mechanisms and develop more effective treatment options for these conditions.
References
[1] Snarskaya ES, Olisova OY, Makatsariya AD, Kochergin NG, Radetskaya L, Bitsadze V, et al. Skin pathologies in pregnancy. J Perinat Med 2019;47:371–80. https://doi.org/10.1515/JPM-2018-0338.
[2] de Lourdes Ribeiro de Carvalho M, Magalhães GM, Leite HV. Update on specific dermatoses of pregnancy. Rev Assoc Med Bras (1992) 2023;69. https://doi.org/10.1590/1806-9282.2023S109.
[3] Ambros-Rudolph CM, Müllegger RR, Vaughan-Jones SA, Kerl H, Black MM. 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. https://doi.org/10.1016/J.JAAD.2005.12.012.
[4] Balakirski G, Novak N. Atopic dermatitis and pregnancy. J Allergy Clin Immunol 2022;149:1185–94. https://doi.org/10.1016/J.JACI.2022.01.010.
[5] Vaughan Jones SA, Hern S, Nelson-Piercy C, Seed PT, Black MM. 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. https://doi.org/10.1046/J.1365-2133.1999.02923.X.
[6] Himeles JR, Pomeranz MK. Recognizing, Diagnosing, and Managing Pregnancy Dermatoses. Obstetrics and Gynecology 2022;140:679–95. https://doi.org/10.1097/AOG.0000000000004938.
[7] Himeles JR, Pomeranz MK. Recognizing, Diagnosing, and Managing Pregnancy Dermatoses. Obstetrics and Gynecology 2022;140:679–95. https://doi.org/10.1097/AOG.0000000000004938.
[8] Massone C, Cerroni L, Heidrun N, Brunasso AMG, Nunzi E, Gulia A, et al. Histopathological diagnosis of atopic eruption of pregnancy and polymorphic eruption of pregnancy: a study on 41 cases. Am J Dermatopathol 2014;36:812–21. https://doi.org/10.1097/DAD.0000000000000067.
[9] Roth MM, Cristodor P, Kroumpouzos G. Prurigo, pruritic folliculitis, and atopic eruption of pregnancy: Facts and controversies. Clin Dermatol 2016;34:392–400. https://doi.org/10.1016/J.CLINDERMATOL.2016.02.012.
[10] Lawley TJ, Hertz K, Wade T, Ackerman A, Katz S. Pruritic urticarial papules and plaques of pregnancy. JAMA 1979:1696–9.
[11] Taylor D, Pappo E, Aronson IK. Polymorphic eruption of pregnancy. Clin Dermatol 2016;34:383–91. https://doi.org/10.1016/J.CLINDERMATOL.2016.02.011.
[12] Ambros-Rudolph CM. Dermatoses of pregnancy - clues to diagnosis, fetal risk and therapy. Ann Dermatol 2011;23:265–75. https://doi.org/10.5021/AD.2011.23.3.265.
[13] Roth MM. Pregnancy dermatoses: diagnosis, management, and controversies. Am J Clin Dermatol 2011;12:25–41. https://doi.org/10.2165/11532010-000000000-00000.
[14] Petropoulou H, Georgala S, Katsambas AD. Polymorphic eruption of pregnancy. Int J Dermatol 2006;45:642–8. https://doi.org/10.1111/J.1365-4632.2006.02715.X.
[15] Zejnullahu VA, Zejnullahu VA. Polymorphic eruption of pregnancy. Dermatol Reports 2022;15. https://doi.org/10.4081/DR.2022.9546.
[16] Piechota J, Jelski W. Intrahepatic Cholestasis in Pregnancy: Review of the Literature. J Clin Med 2020;9. https://doi.org/10.3390/JCM9051361.
[17] 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;35:8566–70. https://doi.org/10.1080/14767058.2021.1988924.
[18] Smith DD, Rood KM. Intrahepatic Cholestasis of Pregnancy. Clin Obstet Gynecol 2020;63:134–51. https://doi.org/10.1097/GRF.0000000000000495.
[19] Pusl T, Beuers U. Intrahepatic cholestasis of pregnancy. Orphanet J Rare Dis 2007;2. https://doi.org/10.1186/1750-1172-2-26.
[20] Williamson C, Geenes V. Intrahepatic cholestasis of pregnancy. Obstetrics and Gynecology 2014;124:120–33. https://doi.org/10.1097/AOG.0000000000000346.
[21] Intong LRA, Murrell DF. Pemphigoid gestationis: pathogenesis and clinical features. Dermatol Clin 2011;29:447–52. https://doi.org/10.1016/J.DET.2011.03.002.
[22] Sävervall C, Sand FL, Thomsen SF. Pemphigoid gestationis: current perspectives. Clin Cosmet Investig Dermatol 2017;10:441–9. https://doi.org/10.2147/CCID.S128144.
[23] Lipozenčić J, Ljubojevic S, Bukvić-Mokos Z. Pemphigoid gestationis. Clin Dermatol 2012;30:51–5. https://doi.org/10.1016/J.CLINDERMATOL.2011.03.009.
[24] Cohen S, Strowd LC, Pichardo RO. Pemphigoid gestationis: a case series and review of the literature. J Dermatolog Treat 2018;29:815–8. https://doi.org/10.1080/09546634.2018.1459034.
[25] Huilaja L, Mäkikallio K, Tasanen K. Gestational pemphigoid. Orphanet J Rare Dis 2014;9. https://doi.org/10.1186/S13023-014-0136-2.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Paulina Polańska
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Stats
Number of views and downloads: 32
Number of citations: 0