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Dermatoses of Pregnancy

Specific Dermatoses of Pregnancy
»	Name four pregnancy-specific dermatological disorders
»	What is pruritic urticarial papules and plaques of pregnancy?
»	Does PUPPP have any associated morbidity?
»	How is PUPPP treated?
»	From which dermatosis of pregnancy must PUPPP be differentiated?
»	What is pemphigoid gestationis?
»	What are the antigens associated with the development on pemphigoid gestationis?
»	Which histocompatibility leukocyte antigen (HLA) types have been associated with pemphigoid gestationis?
»	Compare PUPPP and pemphigoid gestationis.
»	What is atopic eruption of pregnancy?
»	What is intrahepatic cholestasis of pregnancy?
»	What is the epidemiology of ICP?
»	Are there specific laboratory findings to establish the diagnosis?
»	What risks and outcomes are associated with intrahepatic cholestasis of pregnancy?
»	How is cholestasis of pregnancy treated?
»	Is impetigo herpetiformis a distinct clinical disease?
»	Are there lab findings associated with impetigo herpetiformis?
»	What is the treatment for impetigo herpetiformis?
Physiologic Skin Changes in Pregnancy
»	List the physiologic skin changes that can occur as a normal part of pregnancy.
»	What are some of the normal pigmentary changes that can be associated with pregnancy?
»	Why do these pigmentary changes occur?
»	How does pregnancy affect patients with melanoma?
»	Is pregnancy associated with changes in hair growth?
»	List the vascular changes that can occur in pregnancy.
»	What factors influence the development of striae distensae (commonly known as “stretch marks”)?
»	Discuss two cutaneous tumors often associated with pregnancy.
»	Do some diseases improve with pregnancy?
»	Do some mucocutaneous diseases worsen in pregnancy?

Do some diseases improve with pregnancy?

Yes. Examples of such diseases include
• Psoriasis
• Rheumatoid arthritis
• Systemic lupus erythematosus
• Hidradenitis suppurativa
• Fox-Fordyce disease

The regression of psoriasis, rheumatoid arthritis, and systemic lupus erythematosus is thought to be related to the suppressed maternal immunity of pregnancy. Improvement of hidradenitis suppurativa and Fox-Fordyce disease is possibly secondary to the decreased apocrine gland activity in pregnancy.

Oumeish OY, Al-Fouzan AW: Miscellaneous diseases affected by pregnancy, Clin Dermatol 24(2):113–117, 2006.

Raychaudhuri SP, Navare T, Gross J, et al: Clinical course of psoriasis during pregnancy, Int J Dermatol 42(7):518–520, 2003.