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The skin in pregnancy 

The skin in pregnancy

The skin in pregnancy

Fenella Wojnarowska

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date: 24 April 2017

Pregnancy dermatoses are common, and because they are usually very itchy may ruin the life of the pregnant woman. It is particularly important to recognize when itch is due to intrahepatic cholestasis of pregnancy, which has important implications for the health of both mother and fetus (see Chapter 14.9).

Atopic eruption of pregnancy—affects 1/300 pregnancies, typically with an eczematous eruption over abdomen and limbs. Treatment is difficult: there is a dilemma in balancing the need for treatment with the wish to minimize the use of potent topical steroids that will be absorbed and may affect the fetus.

Polymorphic eruption of pregnancy—affects about 1 in 240 pregnancies, usually beginning with red papules and plaques on the abdomen and thighs before spreading more widely. Treatment is with reassurance and emollients, with steroids avoided if possible.

Pemphigoid gestationis—the most severe of the pregnancy dermatoses. It occurs in 1 in 50 000 pregnancies and is due to circulating antibodies against the skin basement membrane zone. The eruption begins around the umbilicus and spreads to the whole trunk, limbs, hands and feet. Systemic steroids are usually required. Transplacental transmission to the fetus may occur. Recurrence in future pregnancies is to be expected.

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