Impact de la grossesse sur le psoriasis

Psoriasis and pregnancy

Résumé

On observe au cours de la grossesse une amélioration spontanée de diverses maladies inflammatoires, y compris le psoriasis pour la majorité des parturientes. Les changements hormonaux durant cette période peuvent jouer un rôle dans l’amélioration du psoriasis en induisant un état de tolérance immunitaire transitoire, en favorisant une réponse de type T helper 2 (Th2), et en réduisant les phénomènes inflammatoires associés au psoriasis. Ce serait plus le ratio œstrogènes/progestérone que les valeurs relatives respectives des taux d’hormones circulantes elles-mêmes qui pourrait favoriser l’amélioration du psoriasis. Ilyaun risque de rebond du psoriasis dans les premiers mois du post-partum. L’allaitement semble avoir moins d’influence sur l’histoire naturelle des lésions cutanées.

Abstract

During pregnancy there is spontaneous improvement in various inflammatory diseases, including psoriasis for the majority of women. Hormonal changes during pregnancy may play a role in improving psoriasis by promoting a state of transient immune tolerance, promoting a TH2-type response, and lowering the inflammatory cascades of psoriasis. It is more the ratio of estrogens to progesterone than the respective relative levels of the circulating hormones themselves that may improve psoriasis. There is a risk of psoriasis flare in the first few months postpartum. Breastfeeding seems to have less influence on the natural history of skin lesions.

Références

  1. 1.

    Boehncke WH, Schon MP. Psoriasis. Lancet 2015;386:983–94.

    CAS  Article  Google Scholar 

  2. 2.

    Ceovic R, Mance M, Mokos BZ, Svetec M, Kostovic K, Buzina1 DS. Psoriasis: female skin changes in various hormonal stages throughout life-puberty, pregnancy, and menopause. BioMed Res Int 2013. doi: https://doi.org/10.1155/2013/571912.

  3. 3.

    Oumeish OY, Fouzan AWS. Miscellaneous diseases affected by pregnancy. Clin Dermatol 2006; 24: 113–7.

    Article  Google Scholar 

  4. 4.

    Lane CG, Crawford GM. Psoriasis: a statistical study of 231 cases. Arch Derm Chicago 1937; 35: 1051–61.

    CAS  Google Scholar 

  5. 5.

    Lomholt G. Psoriasis: prevalence, spontaneous course, and genetics: a census study on the prevalence of skin diseases on the Faroe islands. Copenhagen, Denmark: GEC-Gad, 1963.

    Google Scholar 

  6. 6.

    Farber EM, Bright RD, Nall ML. Psoriasis: a questionnaire survey of 2,144 patients. Arch Dermatol 1968;98:248–59.

    CAS  Article  Google Scholar 

  7. 7.

    Braun-Falco O, Burg G, Farber EM. Psoriasis: a questionnaire study of 536 patients. Munch Med Wochenschr 1972; 114: 1105–10.

    CAS  PubMed  Google Scholar 

  8. 8.

    Farber EM, Nall ML. The natural history of psoriasis in 5,600 patients. Dermatologica 1974; 148: 1–18.

    CAS  Article  Google Scholar 

  9. 9.

    Dunna SF, Finlay AY. Psoriasis: improvement during and worsening after pregnancy. Br J Dermatol 1989; 120: 584.

    CAS  Article  Google Scholar 

  10. 10.

    Boyd AS, Morris LF, Phillips CM, Menter MA. Psoriasis and pregnancy: hormone and immune system interaction. Int J Dermatol 1996; 35: 169–72.

    CAS  Article  Google Scholar 

  11. 11.

    Park BS, Youn JI. Factors influencing psoriasis: an analysis based upon the extent of involvement and clinical type. J Dermatol 1998;25:97–102.

    CAS  Article  Google Scholar 

  12. 12.

    Mowad CM, Margolis DJ, Halpern AC, Suri B, Synnestvedt M, Guzzo CA. Hormonal influences on women with psoriasis. Cutis 1998; 61:257–60.

    CAS  PubMed  Google Scholar 

  13. 13.

    Murase JE, Chan KK, Garite TJ, Cooper DM, Weinstein GD. Hormonal effect on psoriasis in pregnancy and post-partum. Arch Dermatol 2005; 141:601–6.

    CAS  Article  Google Scholar 

  14. 14.

    Raychaudhuri SP, Navare T, Gross J, Raychaudhuri SK. Clinical course of psoriasis during pregnancy. Int J Dermatol 2003;42:518–20.

    Article  Google Scholar 

  15. 15.

    Piccinni MP, Scaletti C, Maggi E, Romagnani S. Role of hormone-controlled Th1- and Th2-type cytokines in successful pregnancy. J Neuroimmunol 2000; 109: 30–3.

    CAS  Article  Google Scholar 

  16. 16.

    Elenkov IJ, Wilder RL, Bakalov VK, et al. IL-12, TNF-alpha, and hormonal changes during late pregnancy and early postpartum: implications for autoimmune disease activity during these times. J Clin Endocrinol Metab 2001; 86:4933–8.

    CAS  PubMed  Google Scholar 

  17. 17.

    Tulchinsky D, Hobel CJ, Yeager E, Marshall JR. Plasma estrone, estradiol, estriol, progesterone, and 17-hydroxyprogesterone in human pregnancy, I: normal pregnancy. Am J Obstet Gynecol 1972; 112:1095–100.

    CAS  Article  Google Scholar 

  18. 18.

    Kanda N, Watanabe S. Regulatory roles of sex hormones in cutaneous biology and immunology. J Dermatol Sci 2005; 38: 1–7.

    CAS  Article  Google Scholar 

  19. 19.

    Cutolo M, Brizzolara R, Atzeni F, Capellino S, Straub RH, Puttini PCS. The immunomodulatory effects of estrogens: clinical relevance in immune-mediated rheumatic Diseases. Ann N Y Acad Sci 2010; 1193:36–42.

    CAS  Article  Google Scholar 

  20. 20.

    Pennell LM, Galligan CL, Fish EN. Sex affects immunity. J Autoimmun 2012; 38: 282–91.

    Article  Google Scholar 

  21. 21.

    Szekeres-Bartho J, Barakonyi A, Par G, Polgar B, Palkovics T, Szereday L. Progesterone as an immunomodulatory molecule. Int Immunopharmacol 2001; 1: 1037–48.

    CAS  Article  Google Scholar 

  22. 22.

    Straub RH. The complex role of estrogens in inflammation. Endocr Rev 2007: 521–74.

  23. 23.

    Salem ML. Estrogen, a double-edged sword: modulation of TH1- and TH2-mediated inflammations by differential regulation of TH1/TH2 cytokine production. Curr Drug Targets 2004; 3: 97–104.

    CAS  Article  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to Marie-Aleth Richard.

Additional information

Liens d’intérêt

Consultante ou oratrice pourMSD, Abbvie, Pfizer, Janssen-Cilag, Novartis, Eli-Lilly, Leo Pharma, Medac, Nordic, Boehringer et UCB. Investigateur pour Boehringer, Pfizer, Jansen-Cilag, Novartis, Eli-Lilly et Amgen.

About this article

Verify currency and authenticity via CrossMark

Cite this article

Richard, MA. Impact de la grossesse sur le psoriasis. Eur J Dermatol 30, 3–7 (2020). https://doi.org/10.1684/ejd.2020.3885

Download citation

Mots clés

  • psoriasis
  • grossesse
  • allaitement
  • post-partum

Key words

  • psoriasis
  • pregnancy
  • breastfeeding
  • post-partum