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Dermatoses in Pregnancy

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Common Dermatologic Conditions in Primary Care

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Abstract

Pregnancy dermatoses describe a set of extremely pruritic dermatologic disorders that uniquely present in the gestational period. Those who care for pregnant women are left to try to differentiate these conditions. They are pruritic urticarial papules and plaques of pregnancy (PUPPP), pemphigoid gestationis, atopic eruption of pregnancy, and intrahepatic cholestasis of pregnancy. While the most common of these, atopic eruption of pregnancy and PUPPP, are benign, self-limiting diseases that have no implications for the fetus, pemphigoid gestationis and intrahepatic cholestasis of pregnancy both pose a risk to the fetus and are associated with adverse outcomes. A clinician’s ability to distinguish these conditions can impact both the mother and the fetus.

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References

  1. Lawley TJ, Hertz KC, Wade TR, Ackerman AB, Katz SI. Pruritic urticarial papules and plaques of pregnancy. JAMA. 1979;241:1696–9.

    CAS  PubMed  Google Scholar 

  2. Taylor D, Pappo E, Aronson IK. Polymorphic eruption of pregnancy. Clin Dermatol. 2016;34(3):383–91.

    PubMed  Google Scholar 

  3. Rudolph CM, Al-Fares S, Vaughan-Jones SA, Mullegger RR, Kerl H, Black MM. Polymorphic eruption of pregnancy: clinicopathology and potential trigger factors in 181 patients. Br J Dermatol. 2006;154(1):54–60.

    CAS  PubMed  Google Scholar 

  4. 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(3):395–404.

    PubMed  Google Scholar 

  5. Ohel I, Levy A, Silberstein T, Holcberg G, Sheiner E. Pregnancy outcome of patients with pruritic urticarial papules and plaques of pregnancy. J Matern Fetal Neonatal Med. 2006;19(5):305–8.

    PubMed  Google Scholar 

  6. Dehdashti AL, Wikas SM. Pruritic urticarial papules and plaques of pregnancy occurring postpartum. Cutis. 2015;95(6):344–7.

    PubMed  Google Scholar 

  7. Sadik CD, Lima AL, Zillikens D. Pemphigoid gestationis: toward a better understanding of the etiopathogenesis. Clin Dermatol. 2016;34(3):378–82.

    PubMed  Google Scholar 

  8. Castro LA, Lundell RB, Krause PK, Gibson LE. Clinical experience in pemphigoid gestationis: report of 10 cases. J Am Acad Dermatol. 2006;55(5):823–8.

    PubMed  Google Scholar 

  9. Henry S. Recognizing presentations of pemphigoid gestationis: a case study. Case Rep Obstet Gynecol. 2014;2014:415163.

    PubMed  PubMed Central  Google Scholar 

  10. Singla A, Shree S, Mehta S. Pregnancy with pemphigoid gestationis: a rare entity. J Clin Diagn Res. 2016;10(7):QD06–7.

    PubMed  PubMed Central  Google Scholar 

  11. Intong LR, Murrell DF. Pemphigoid gestationis: current management. Dermatol Clin. 2011;29(4):621–8.

    CAS  PubMed  Google Scholar 

  12. Cobo MF, Santi CG, Maruta CW, Aoki V. Pemphigoid gestationis: clinical and laboratory evaluation. Clinics (Sao Paulo). 2009;64(11):1043–7.

    Google Scholar 

  13. Arakawa M, Ohata C, Tsuruta D, et al. A severe and prolonged case of pemphigoid gestationis successfully treated with combination therapies. Br J Dermatol. 2016;174(4):925–7.

    CAS  PubMed  Google Scholar 

  14. Tani N, Kimura Y, Kawakami C, et al. Clinical and immunological profiles of 25 patients with pemphigoid gestationis. Br J Dermatol. 2015;172(1):120–9.

    CAS  PubMed  Google Scholar 

  15. Tran TT, Ahn J, Reau NS. ACG clinical guideline: liver disease and pregnancy. Am J Gastroenterol. 2016;111(2):176–94.

    CAS  PubMed  Google Scholar 

  16. Rook M, Vargas J, Caughey A, Bacchetti P, Rosenthal P, Bull L. Fetal outcomes in pregnancies complicated by intrahepatic cholestasis of pregnancy in a Northern California cohort. PLoS One. 2012;7(3):e28343.

    CAS  PubMed  PubMed Central  Google Scholar 

  17. Martineau M, Raker C, Powrie R, Williamson C. Intrahepatic cholestasis of pregnancy is associated with an increased risk of gestational diabetes. Eur J Obstet Gynecol Reprod Biol. 2014;176:80–5.

    PubMed  Google Scholar 

  18. Turunen K, Helander K, Mattila KJ, Sumanen M. Intrahepatic cholestasis of pregnancy is common among patients’ first-degree relatives. Acta Obstet Gynecol Scand. 2013;92(9):1108–10.

    PubMed  Google Scholar 

  19. Madazli R, Yuksel MA, Oncul M, Tuten A, Guralp O, Aydin B. Pregnancy outcomes and prognostic factors in patients with intrahepatic cholestasis of pregnancy. J Obstet Gynaecol. 2015;35(4):358–61.

    CAS  PubMed  Google Scholar 

  20. Zamah AM, El-Sayed YY, Milki AA. Two cases of cholestasis in the first trimester of pregnancy after ovarian hyperstimulation. Fertil Steril. 2008;90(4):1202. e7–10.

    Google Scholar 

  21. Brouwers L, Koster MP. Page-Christiaens. Intrahepatic cholestasis of pregnancy: maternal and fetal outcomes associated with elevated bile acid levels. Am J Obstet Gynecol. 2015;212(1):100.e1–7.

    CAS  Google Scholar 

  22. Lee RH, Kwok KM, Ingles S, et al. Pregnancy outcomes during an era of aggressive management for intrahepatic cholestasis of pregnancy. Am J Perinatol. 2008;25(6):341–5.

    PubMed  Google Scholar 

  23. Martineau MG, Raker C, Dixon PH, et al. The metabolic profile of intrahepatic cholestasis of pregnancy is associated with impaired glucose tolerance, dyslipidemia, and increased fetal growth. Diabetes Care. 2015;38(2):243–8.

    PubMed  Google Scholar 

  24. Raz Y, Lavie A, Vered Y, et al. Severe intrahepatic cholestasis of pregnancy is a risk factor for preeclampsia in singleton and twin pregnancies. Am J Obstet Gynecol. 2015;213(3):395.e1–8.

    Google Scholar 

  25. Bacq Y, Sentilhes L, Reyes HB, et al. Efficacy of ursodeoxycholic acid in treating intrahepatic cholestasis of pregnancy: a meta-analysis. Gastroenterology. 2012;143(6):1492–501.

    CAS  Google Scholar 

  26. Roth MM, Cristodor P, Kroumpouzos G. Prurigo, pruritic folliculitis, and atopic eruption of pregnancy: facts and controversies. Clin Dermatol. 2016;34(3):392–400.

    PubMed  Google Scholar 

  27. Massone C, Cerroni L, Heidrun N, et al. Histopathological diagnosis of atopic eruption of pregnancy and polymorphic eruption of pregnancy: a study on 41 cases. Am J Dermatopathol. 2014;36(10):812–21.

    PubMed  Google Scholar 

  28. Koutroulis I, Papoutsis J, Kroumpouzos G. Atopic dermatitis in pregnancy: current status and challenges. Obstet Gynecol Surv. 2011;66(10):654–63.

    PubMed  Google Scholar 

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Correspondence to Renell S. Dupree .

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Dupree, R.S., Smith, S. (2019). Dermatoses in Pregnancy. In: Russell, J., Ryan Jr., E. (eds) Common Dermatologic Conditions in Primary Care. Current Clinical Practice. Humana, Cham. https://doi.org/10.1007/978-3-030-18065-2_21

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  • DOI: https://doi.org/10.1007/978-3-030-18065-2_21

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  • Publisher Name: Humana, Cham

  • Print ISBN: 978-3-030-18064-5

  • Online ISBN: 978-3-030-18065-2

  • eBook Packages: MedicineMedicine (R0)

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