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
Lawley TJ, Hertz KC, Wade TR, Ackerman AB, Katz SI. Pruritic urticarial papules and plaques of pregnancy. JAMA. 1979;241:1696–9.
Taylor D, Pappo E, Aronson IK. Polymorphic eruption of pregnancy. Clin Dermatol. 2016;34(3):383–91.
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.
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.
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.
Dehdashti AL, Wikas SM. Pruritic urticarial papules and plaques of pregnancy occurring postpartum. Cutis. 2015;95(6):344–7.
Sadik CD, Lima AL, Zillikens D. Pemphigoid gestationis: toward a better understanding of the etiopathogenesis. Clin Dermatol. 2016;34(3):378–82.
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.
Henry S. Recognizing presentations of pemphigoid gestationis: a case study. Case Rep Obstet Gynecol. 2014;2014:415163.
Singla A, Shree S, Mehta S. Pregnancy with pemphigoid gestationis: a rare entity. J Clin Diagn Res. 2016;10(7):QD06–7.
Intong LR, Murrell DF. Pemphigoid gestationis: current management. Dermatol Clin. 2011;29(4):621–8.
Cobo MF, Santi CG, Maruta CW, Aoki V. Pemphigoid gestationis: clinical and laboratory evaluation. Clinics (Sao Paulo). 2009;64(11):1043–7.
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.
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.
Tran TT, Ahn J, Reau NS. ACG clinical guideline: liver disease and pregnancy. Am J Gastroenterol. 2016;111(2):176–94.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Roth MM, Cristodor P, Kroumpouzos G. Prurigo, pruritic folliculitis, and atopic eruption of pregnancy: facts and controversies. Clin Dermatol. 2016;34(3):392–400.
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.
Koutroulis I, Papoutsis J, Kroumpouzos G. Atopic dermatitis in pregnancy: current status and challenges. Obstet Gynecol Surv. 2011;66(10):654–63.
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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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