Skip to main content

Dermatology and Pregnancy

  • Chapter
  • First Online:
Dermatology in Public Health Environments

Abstract

Cutaneous manifestations during pregnancy can be divided into physiologic and pathologic, resulting from many changes in the mother’s body. They encompass physiologic changes, dermatoses affected by the gestational condition, and dermatoses of the gestational period per se. The names and classification of these dermatoses have gone through many changes over the years, and recently were all simplified and summarized into the pregnancy-specific dermatoses: pemphigoid gestationis, polymorphic eruption of pregnancy, intrahepatic cholestasis of pregnancy, and atopic eruption of pregnancy. Pregnancy has a tendency to affect the course of the immunomediated diseases, with improvement in most of the cases, such as psoriasis, and worsening of other diseases, such as pemphigus, dermatopolymyositis, and lupus erythematosus. A watchful diagnosis and patient follow-up are crucial for treatment aimed at the prevention of maternal and fetal complications.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

References

  1. Alves GF, Nogueira LSC, Varella TCN. Dermatologia e gestação. An Bras Dermatol. 2005;80(2):179–86.

    Article  Google Scholar 

  2. Neves C, Medina JL, Delgado JL. Alterações endócrinas e imuno-modulação na gradidez. Arq Med. 2007;21(5/6):175–82.

    Google Scholar 

  3. Muzaffar F, Hussain I, Haroon TS. Physiologic skin changes during pregnancy: a study of 140 cases. Int J Dermatol. 1998;37:429–31.

    Article  PubMed  CAS  Google Scholar 

  4. Elling SV, Powell FC. Physiological changes in the skin during pregnancy. Clin Dermatol. 1997;15:35–43.

    Article  PubMed  CAS  Google Scholar 

  5. Martin AG, Leal-Khouri S. Physiologic skin changes associated with pregnancy. Int J Dermatol. 1992;31:375–8.

    Article  PubMed  CAS  Google Scholar 

  6. Kumari R, Jaisankar TJ, Thappa DM. A clinical study of skin changes in pregnancy. Indian J Dermatol Venereol Leprol. 2007;73:141.

    PubMed  Google Scholar 

  7. Zanini M, et al. Dermatoses gestacionais. Med Cutan Iber Lat Am. 2004;32(4):139–50.

    Google Scholar 

  8. Wong RC. Physiologic skin changes in pregnancy. J Am Acad Dermatol. 1984;10:929–40.

    Article  PubMed  CAS  Google Scholar 

  9. Pennoyer JW, Grin CM, Driscoll MS, Dry SM, Walsh SJ, Gelineau JP, et al. Changes in size of melanocytic nevi during pregnancy. J Am Acad Dermatol. 1997;36:378–82.

    Article  PubMed  CAS  Google Scholar 

  10. Wong RC, Ellis CN. Physiologic skin changes in pregnancy. Semin Dermatol. 1989;8:7–11.

    PubMed  CAS  Google Scholar 

  11. Carneiro SCS, Abulafia LA. Pele na gestação. Ver Bras Reumatol. 2005;45(3):146–52.

    Google Scholar 

  12. Holmes RC, Black MM, Dann J, James DC, Bhogal B. A comparative study of toxic erythema of pregnancy and herpes gestationis. Br J Dermatol. 1982;106:499–510.

    Article  PubMed  CAS  Google Scholar 

  13. Holmes RC, Black MM. The specific dermatoses of pregnancy. J Am Acad Dermatol. 1983;8:405–12.

    Article  PubMed  CAS  Google Scholar 

  14. Zoberman E, Farmer ER. Pruritic folliculitis of pregnancy. Arch Dermatol. 1981;117:20–2.

    Article  PubMed  CAS  Google Scholar 

  15. Shornick JK. Dermatoses of pregnancy. Semin Cutan Med Surg. 1998;17:172–81.

    Article  PubMed  CAS  Google Scholar 

  16. Ambros-Rudolph CM. Dermatoses of pregnancy – clues to diagnosis, fetal risk and therapy. Ann Dermatol. 2011;23(3):265–75.

    Google Scholar 

  17. Ambros-Rudolph CM, Mullegger RR, Vaughan-Jones AS, Kerl H, Black MM. The specific dermatoses of pregnancy revisited and reclassified: results of a retrospective two-center study on 505 pregnancy patient. J Am Acad Dermatol. 2006;54:395–404.

    Article  PubMed  Google Scholar 

  18. Ambros-Rudolph CM. Disorders of pregnancy. In: Burgdorf WHC, Plewig G, Wolff HH, Landthaler M, editors. Braun-Falco’s dermatology. 3rd ed. Heidelberg: Springer Medizin Verlag; 2009. p. 1160–9.

    Chapter  Google Scholar 

  19. Jones SAV, Black MM. Pregnancy dermatoses. J Am Acad Dermatol. 1999;40:233–41.

    Article  Google Scholar 

  20. Winton GB, Major MC, Lewis CW. Dermatoses of pregnancy. J Am Acad Dermatol. 1982;6:977–98.

    Article  CAS  PubMed  Google Scholar 

  21. Holmes RC, Black MM. Herpes gestationis. Dermatol Clin. 1983;1:195–203.

    Article  Google Scholar 

  22. Black MM. New observations on pemphigoid gestationis. Dermatology. 1994;189:50–1.

    Article  PubMed  Google Scholar 

  23. Holmes RC, Black MM, James DC. HLA-DR and herpes gestationis. J Invest Dermatol. 1984;83:78–9.

    Article  PubMed  CAS  Google Scholar 

  24. Kolodny RC. Herpes gestationis. A new assessment of incidence, diagnosis, and fetal prognosis. Am J Obstet Gynecol. 1969;104:39–45.

    Article  PubMed  CAS  Google Scholar 

  25. Shornick JK. Herpes gestationis. Dermatol Clin. 1993;11:527–33.

    Article  PubMed  CAS  Google Scholar 

  26. Kroumpouzos G, Cohen LM. Specific dermatoses of pregnancy: an evidence-based systematic review. Am J Obstet Gynecol. 2003;188:1083–92.

    Article  PubMed  Google Scholar 

  27. Roger D, Vaillant L, Lorette G, et al. Specific pruritic diseases of pregnancy. Arch Dermatol. 1994;130:734–9.

    Article  PubMed  CAS  Google Scholar 

  28. Sasseville D, Wilkinson RD, Schnader JY. Dermatoses of pregnancy. Int J Dermatol. 1981;20:223–41.

    Article  PubMed  CAS  Google Scholar 

  29. Wöhrl S, Geusau A, Karlhofer F, Derfler K, Stingl G, Zillikens D. Pemphigoid gestationis: treatment with immunoapheresis. J Dtsch Dermatol Ges. 2003;1:126–30.

    Article  PubMed  Google Scholar 

  30. Bourne G. Toxaemic rash of pregnancy. Proc R Soc Med. 1962;55:462–4.

    PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  32. Ambros-Rudolph CM, Black MM. Polymorphic eruption of pregnancy. In: Black MM, Ambros-Rudolph CM, Edwards L, Lynch P, editors. Obstetric and gynecologic dermatology. 3rd ed. London: Elsevier Limit; 2008. p. 49–56.

    Chapter  Google Scholar 

  33. Vaughan Jones SA, Hern S, Nelson-Piercy C, Seed PT, Black MM. A prospective study of 200 women with dermatoses of pregnancy correlating clinical findings with hormonal and immunopathological profiles. Br J Dermatol. 1999;141:71–81.

    Article  PubMed  CAS  Google Scholar 

  34. Ahmadi S, Powell F. Pruritic urticarial papules and plaques of pregnancy: current status. Australas J Dermatol. 2005;46:53–8.

    Article  PubMed  Google Scholar 

  35. Lammert F, Marschall HU, Glantz A, Matern S. Intrahepatic cholestasis of pregnancy: molecular pathogenesis, diagnosis and management. J Hepatol. 2000;33:1012–21.

    Article  PubMed  CAS  Google Scholar 

  36. Reyes H. The spectrum of liver and gastrointestinal disease seen in cholestasis of pregnancy. Gastroenterol Clin N Am. 1992;21:905–21.

    CAS  Google Scholar 

  37. Ambros-Rudolph CM, Glatz M, Trauner M, Kerl H, Müllegger RR. The importance of serum bile acid level analysis and treatment with ursodeoxycholic acid in intrahepatic cholestasis of pregnancy: a case series from central Europe. Arch Dermatol. 2007;143:757–62.

    Article  PubMed  CAS  Google Scholar 

  38. Brites D, Rodrigues CM, Oliveira N, Cardoso M, Graça LM. Correction of maternal serum bile acid profile during ursodeoxycholic acid therapy in cholestasis of pregnancy. J Hepatol. 1998;28:91–8.

    Article  PubMed  CAS  Google Scholar 

  39. Carter J. Serum bile acids in normal pregnancy. Br J Obstet Gynaecol. 1991;98:540–3.

    Article  PubMed  CAS  Google Scholar 

  40. Glantz A, Marschall HU, Mattsson LA. Intrahepatic cholestasis of pregnancy: relationships between bile acid levels and fetal complication rates. Hepatology. 2004;40:467–74.

    Article  PubMed  Google Scholar 

  41. Zapata R, Sandoval L, Palma J, Hernández I, Ribalta J, Reyes H, et al. Ursodeoxycholic acid in the treatment of intrahepatic cholestasis of pregnancy. A 12-year experience. Liver Int. 2005;25:548–54.

    Article  CAS  PubMed  Google Scholar 

  42. Kondrackiene J, Beuers U, Kupcinskas L. Efficacy and safety of ursodeoxycholic acid versus cholestyramine in intrahepatic cholestasis of pregnancy. Gastroenterology. 2005;129:894–901.

    Article  CAS  PubMed  Google Scholar 

  43. Reed BR. Dermatologic drugs, pregnancy and lactation. Arch Dermatol. 1997;133:894–8.

    Article  CAS  PubMed  Google Scholar 

  44. Semkova K, Black MM. Pemphigoid gestacionais: current insights into pathogenesis and treatment. Eur J Obstet Gynecol Reprod Biol. 2009;145:138–44.

    Article  PubMed  Google Scholar 

  45. Teixeira V, Coutinho I, Gameiro R, Vieira R, Gonçalo M. Dermatoses específicas da gravidez. Acta Medica Port. 2013;26(5):593–600.

    Google Scholar 

  46. Geenes V, Williamson C. Intrahepatic cholestasis of pregnancy. World J Gastroenterol. 2009;15:2049–66.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Gilvan Ferreira Alves Msc .

Editor information

Editors and Affiliations

Glossary

Dermatosis

Any disease of the skin.

Eczema

An inflammatory condition of the skin attended with itching and the exudation of serous matter.

Histocompatibility

The condition of having antigenic similarities such that cells or tissues transplanted from one (the donor) to another (the recipient) are not rejected.

Immune complex

Aggregate of an antigen and its specific antibody.

Microabrasion

Technique used in removing surface stains, using abrasive or erosive substances.

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Alves, G.F., Zanetti, V.T., Viegas, R.M.F. (2018). Dermatology and Pregnancy. In: Bonamigo, R., Dornelles, S. (eds) Dermatology in Public Health Environments. Springer, Cham. https://doi.org/10.1007/978-3-319-33919-1_32

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-33919-1_32

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-33917-7

  • Online ISBN: 978-3-319-33919-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics