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.
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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.
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Richard, MA. Impact de la grossesse sur le psoriasis. Eur J Dermatol 30 (Suppl 1), 3–7 (2020). https://doi.org/10.1684/ejd.2020.3885
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DOI: https://doi.org/10.1684/ejd.2020.3885