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Atopic Dermatitis: Fertility, Pregnancy, and Treatment Perspectives

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Abstract

Hormonal and immunologic changes during pregnancy can contribute to the development of different dermatoses, the most common of which is atopic eruption of pregnancy (AEP). Of atopic dermatitis (AD) cases during pregnancy, 80% are new-onset presentations, while 20% represent recurrences or exacerbations of preexisting disease. Evidence on the effects of previous AD on fertility is limited. Different factors influence women’s desire to conceive in this setting, and it has been hypothesized that barrier defects and systemic inflammation could contribute to biologic infertility, although more data are needed. Clinical practice suggests a tendency toward undertreatment in pregnant woman due to concerns about potential effects on obstetric and fetal outcomes. However, pregnant women should be offered adequate and safe treatments, preferably on an individual basis. The aim of this review was to summarize the evidence on disease course in pregnant women with AD and the challenges associated with its diagnosis and management. We also review the current evidence on the use of conventional and novel systemic therapies for AD in this population.

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  1. Department of Dermatology, Germans Trias i Pujol University Hospital, Autonomous University of Barcelona, Germans Trias i Pujol Research Institute (IGTP), Badalona, Barcelona, Spain

    Mónica Munera-Campos & Jose Manuel Carrascosa

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M. Munera-Campos has received fees for scientific advisory, presentations, and other related activities from AbbVie, LEO Pharma, Janssen, Sanofi, and Galderma. She has also participated as a principal investigator and sub-investigator in clinical trials for Lilly, LEO Pharma, Novartis, Janssen, Sanofi, Pfizer, AbbVie, Almirall, UCB, and Galderma. J.M. Carrascosa has participated as a principal investigator/sub-investigator and has received fees as a speaker or as a member of the expert steering committee for AbbVie, Novartis, Janssen, Lilly, Sandoz, Amgen, Almirall, BMS, Boehringer Ingelheim, Biogen, LEO Pharma, and UCB.

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MM-C and JMC have equally participated in the critical literature review and the writing of this manuscript. All authors have read and approved the final manuscript.

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Munera-Campos, M., Carrascosa, J.M. Atopic Dermatitis: Fertility, Pregnancy, and Treatment Perspectives. Am J Clin Dermatol 25, 55–66 (2024). https://doi.org/10.1007/s40257-023-00821-4

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