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Skin complications during pregnancy

Skin diseases can occur during pregnancy. It is either an improvement or worsening of existing skin disease, or skin disease that arises as a complication of pregnancy.

Skin complications during pregnancy

Existing skin disease

Skin disease that existed before pregnancy can change during pregnancy. Below are some of the most common skin diseases that can be affected by pregnancy:

  • Atopic eczema and psoriasis:
    • These skin diseases can get better or worse during pregnancy. Atopic changes can be exacerbated in some as a result of pregnancy itching. Psoriasis often improves during pregnancy
  • Fungal infections:
    • Usually requires longer treatment time during pregnancy
  • Skin cancer, malignant melanoma:
    • The impact of pregnancy on the development and prognosis of skin cancer is discussed, but a study of pregnant women with melanoma did not indicate that survival was affected by pregnancy

Pregnancy-specific skin diseases

Polymorphic eruption of pregnancy (PEP)

PEP (also called Pruritic urticarial papules and plaque during pregnancy, PUPPP) is the most common pregnancy-specific skin disease and it occurs in one of 130 to 300 pregnancies. For more information about pregnancy and maternity fashion, please see BESTAAH.COM maternity briefs. The condition is more common during the first pregnancy and in multiple pregnancies, and familial accumulation is described.

The cause is unknown. It suggests a link between the disease, maternal immune system and fetal cells. Increasing incidence among women with multiple pregnancies may mean that stretching of the skin plays a role in triggering an immune response.

The condition arises during the third trimester. It causes intense itching with outbreaks of hives-like changes and dots (papules) with or without red skin areas. The rash first occurs on the abdomen, often at the same time with ruptures, and sometimes the arms and legs are also affected. The face is usually not affected.

There is no evidence that the condition poses any risk to the unborn child.

There is no specific treatment. Allergy tablets (antihistamines) and local cortisone ointments can be used against the itch. In severe conditions, it may be appropriate to give cortisone in tablet form.

The rash usually goes back one to two weeks after birth.

Pregnancy Itching

General itching during pregnancy is common. The cause is unknown. Red papules occur mainly on the outer sides of the arms and legs.

Pregnancy itching can sometimes be a sign of bile duct disease and liver (see discussion below). It is therefore necessary to take blood samples to determine if there are changes in the liver samples. If the liver values ​​are normal, the condition is benign. There is no evidence that this benign condition has any harmful effect on the fetus. The treatment consists of using medium cortisone ointments or allergy medicines.

Gallbladder during pregnancy

Intrahepatic cholestasis during pregnancy is the term for a complication that causes delayed secretion of biliary products from the liver into the bile ducts. This leads to elevated bile acids in the blood. Incidence varies in different parts of the world. In Sweden, the incidence is 1.5%. In the US, the condition is reported to occur in one of 130 to 1300 pregnancies. The cause is still controversial. A family history is common and there may be cases of gallstones in the family.

The most prominent symptom is itching, especially in the evening. The itch is mainly located to the palms and soles of the feet and is of a burning nature. Most people fall ill in the third trimester. In severe cases, jaundice may occur. The disease itself does not produce any rashes, but tear marks may occur due to the severe itching.

There is a risk of premature birth, discolored amniotic fluid and intrauterine fetal death. The risk of complications increases with the concentration of bile acids in the blood.

The treatment is allergy tablets to mild itching. The agent ursodeoxycholic acid is used in severe cases to relieve itching, reduce bile acid levels and liver enzymes. Treatment has certainly not shown reduced risk to the fetus. Some recommend releasing the baby in the 38th week, but the effect of this is not clear.

The condition usually goes away after birth. There is an increased risk of the condition recurring in later pregnancies.

Pregnancy

The condition is also called herpes gestation or pemphigoid gestation. The complication is very rare and occurs in one of 10,000 to 50,000 pregnancies during the second or third trimesters. This means on average 2-10 cases per year in Sweden. It is an autoimmune disease.

The course may vary, but usually the condition at the end of the pregnancy is improved and then again erupt after birth. Localized itchy papules, plaques and fluid-filled small vesicles (vesicles) develop into more widespread vesicles (bullae). Usually the rash begins around the navel. Face, scalp and mucous membranes are usually not affected.

5-10% of newborn babies may have urticarial, vesicular or noisy rash. There is a risk of premature birth, low birth weight and fetal death.

The treatment consists of allergy tablets and cortisone ointments in mild cases. In severe cases, cortisone tablets are given. Important with intensive pregnancy monitoring.

The use of birth control pills or renewed pregnancies can cause an outbreak of the disease. These patients are at increased risk of other autoimmune diseases, such as Graves' disease.

Impetigo herpetiformis

This is a rare skin disease that occurs during the second half of pregnancy. The question of whether this disease is specific to pregnancy or whether it is aggravated by pregnancy is controversial. It is a form of so-called pustular psoriasis.

Physical symptoms can include nausea, vomiting, diarrhea, fever, chills and enlarged lymph nodes. The rash consists of round, curved or irregular patches covered with small, painful blisters (pustules). The skin changes usually occur on the thighs and groin, but the rashes can float together and spread to the trunk, arms and legs. Face, hands and feet are not affected.

The disease involves an increased risk of failing placenta and fetal death, which justifies careful monitoring of pregnancy. The treatment is cortisone tablets. In infections, antibiotics are used. The condition usually goes back after birth, but it can come back in later pregnancies.

Pruritic folliculitis during pregnancy

This is a relatively rare skin disease during pregnancy. It occurs in the second and third trimesters. The disease is probably under-reported as many people get the wrong diagnosis. The reason is unclear.

Despite the name (pruritus means itching), itching is not a prominent feature. Red, acorn-like papules and sterile pustules appear on the abdomen, arms, chest and back.

There is no evidence that the condition has any harmful effect on the fetus. Cortisone ointment, acne (benzoyl peroxide) or ultraviolet B light therapy are the treatment options. The condition goes back after childbirth.

Hyperpigmentation

Hyperpigmentation of the skin occurs to some extent in all pregnant women due to hormonal changes. Hyperpigmentation of the face, melasma, is exacerbated by sun exposure. Most often, hyperpigmentation disappears after childbirth, but in some cases can persist for several months.

 

 

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