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American Journal of Clinical Dermatology Mar 2022Pruritus in pregnancy is a common and burdensome symptom that may be a first sign of a pregnancy-specific pruritic disease (atopic eruption of pregnancy, polymorphic... (Review)
Review
Pruritus in pregnancy is a common and burdensome symptom that may be a first sign of a pregnancy-specific pruritic disease (atopic eruption of pregnancy, polymorphic eruption of pregnancy, pemphigoid gestationis, and intrahepatic cholestasis in pregnancy) or a dermatosis coinciding with pregnancy by chance. Despite its high prevalence, pruritus is often underrated by physicians, and data regarding the safety profiles of drugs for pruritus are very limited. In this review, we illustrate the epidemiology, possible pathophysiology, clinical characteristics, and diagnostic workup of various pregnancy-related diseases and discuss antipruritic treatments. The prevalence of pruritus in pregnancy demonstrates the importance of symptom recognition and the need for an holistic approach, taking into account both the potential benefits for the patient and the potential risks to the fetus.
Topics: Cholestasis, Intrahepatic; Exanthema; Female; Humans; Pemphigoid Gestationis; Pregnancy; Pregnancy Complications; Pruritus
PubMed: 35191007
DOI: 10.1007/s40257-021-00668-7 -
Clinical Case Reports Jul 2018Pemphigoid gestationis is a rare autoimmune skin disorder emerging exclusively during pregnancy. Topical and oral glucocorticoids as well as oral antihistamines are the...
Pemphigoid gestationis is a rare autoimmune skin disorder emerging exclusively during pregnancy. Topical and oral glucocorticoids as well as oral antihistamines are the standard medications administered during pregnancy, aiming to relieve pruritus and to suppress extensive blister formation. Obstetricians should be able to recognize and treat this rare clinical condition accordingly.
PubMed: 29988643
DOI: 10.1002/ccr3.1545 -
Clinical Practice and Cases in... Feb 2019
PubMed: 30775676
DOI: 10.5811/cpcem.2018.11.39258 -
Orphanet Journal of Rare Diseases Sep 2014Gestational pemphigoid (pemphigoid gestationis, PG) is a rare autoimmune skin disorder occurring characteristically during pregnancy. Autoantibodies against placental... (Review)
Review
Gestational pemphigoid (pemphigoid gestationis, PG) is a rare autoimmune skin disorder occurring characteristically during pregnancy. Autoantibodies against placental BP180 (also known as BPAG2 or collagen XVII) cause damage to the skin basement membrane, resulting in severe itching and blistering rash over the body and the extremities. The diagnosis of PG is confirmed by immunofluorescence analysis of a skin biopsy, while serum levels of pemphigoid antigen BP180 antibody can be used to assess disease activity. PG with mild symptoms can be treated with topical corticosteroids, while oral corticosteroids are the mainstay in treatment of severe PG. PG usually flares up at the time of delivery, and resolves spontaneously shortly after. However, relapses in subsequent pregnancies are common. As PG has been linked to the risk of prematurity and fetal growth restriction, prenatal monitoring jointly by a dermatologist and an obstetrician is recommended. Mothers should also be informed of the potential risk of re-activation of the disease in subsequent pregnancies and during hormonal contraception.
Topics: Autoantigens; Biopsy; Diagnosis, Differential; Female; Fluorescent Antibody Technique, Direct; Humans; Infant, Newborn; Non-Fibrillar Collagens; Pemphigoid, Bullous; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Prognosis; Collagen Type XVII
PubMed: 25178359
DOI: 10.1186/s13023-014-0136-2 -
Clinical, Cosmetic and Investigational... 2017Many skin diseases can occur in pregnant women. However, a few pruritic dermatological conditions are unique to pregnancy, including pemphigoid gestationis (PG). As PG... (Review)
Review
Many skin diseases can occur in pregnant women. However, a few pruritic dermatological conditions are unique to pregnancy, including pemphigoid gestationis (PG). As PG is associated with severe morbidity for pregnant women and carries fetal risks, it is important for the clinician to quickly recognize this disease and refer it for dermatological evaluation and treatment. Herein, we review the pathogenesis, clinical characteristics, and management of PG.
PubMed: 29184427
DOI: 10.2147/CCID.S128144 -
Skin Therapy Letter 2014The pregnancy-specific skin disorders are pruritic, inflammatory eruptions. The current classification by Ambros-Rudolph et al. includes four entities: pemphigoid...
The pregnancy-specific skin disorders are pruritic, inflammatory eruptions. The current classification by Ambros-Rudolph et al. includes four entities: pemphigoid gestationis (PG), polymorphic eruption of pregnancy (PEP), atopic eruption of pregnancy (AEP), and intrahepatic cholestasis of pregnancy (ICP). Although these disorders are all characterized by intense pruritus during pregnancy, they can be distinguished by timing, morphology, histopathology, treatment and potential for fetal complications. Diagnosis is made by clinical presentation, histology, and immunofluorescence. PEP and AEP typically resolve without sequelae; however, PG may lead to prematurity and low birth weight, and ICP is associated with an increased risk of prematurity, fetal distress, and intrauterine fetal demise. The potential for serious fetal complications necessitates a thorough evaluation of pregnancy-related pruritus. This article will discuss the skin disorders specific to pregnancy, with a focus on clinical presentation, potential for fetal complications, pathogenesis, diagnosis, and treatment.
Topics: Female; Fetal Diseases; Fluorescent Antibody Technique; Humans; Pregnancy; Pregnancy Complications; Pruritus; Skin Diseases
PubMed: 25405676
DOI: No ID Found -
BMJ Case Reports Jun 2018
Topics: Adult; Antipruritics; Female; Histamine H1 Antagonists; Humans; Hydroxyzine; Pemphigoid Gestationis; Prednisone; Pregnancy; Pruritus
PubMed: 29914905
DOI: 10.1136/bcr-2018-225242 -
BMC Veterinary Research Feb 2023Autoimmune subepidermal blistering diseases (AISBDs) are rare skin disorders of animals that were first identified in dogs but several AISBDs are now recognised in other... (Review)
Review
Autoimmune subepidermal blistering diseases (AISBDs) are rare skin disorders of animals that were first identified in dogs but several AISBDs are now recognised in other companion animal species. Most AISBDs in animals are homologues of the human diseases and are thought to share similar pathomechanisms of epidermal and/or mucosal blister formation caused by autoantibodies targeting structural proteins of the basement membrane zone (BMZ). Disruption of their structural function by the autoantibodies and/or recruited inflammation leads to BMZ fragility, which presents clinically as vesicles, bullae and, later, deep erosions and ulcers. Canine AISBDs are the best characterised, particularly the more common variants such as mucous membrane pemphigoid (48%), epidermolysis bullosa acquisita (EBA) (26%), and bullous pemphigoid (10%). Exceedingly rare AISBDs in the dog are junctional EBA, mixed AISBD, type-1 bullous systemic lupus erythematosus, linear IgA dermatosis, and pemphigus gestationis. The diagnosis of a specific AISBD is made by combining the clinical features (breed, age, lesion distribution) with histological evidence of subepithelial clefting, but not all AISBDs can be differentiated in this manner and specialised immunological testing is required. This latter, unfortunately, is not readily available and, therefore, the specific AISBD diagnosis often remains unconfirmed. While this limits further understanding of these diseases, it does not prevent clinicians from treating their patients, as the treatment approaches are similar for the different AISBDs in dogs. This review primarily focuses on canine AISBDs, the species for which these diseases have been best characterised, and shorter descriptions of variants in other species are also provided.
Topics: Humans; Animals; Dogs; Skin; Pemphigus; Epidermis; Autoantibodies; Breeding; Dog Diseases
PubMed: 36849885
DOI: 10.1186/s12917-023-03597-1