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Australian Journal of General Practice Dec 2021Women with rashes or itchy skin during pregnancy will often present initially to the general practitioner. Knowledge of the specific dermatoses of pregnancy...
BACKGROUND
Women with rashes or itchy skin during pregnancy will often present initially to the general practitioner. Knowledge of the specific dermatoses of pregnancy will assist in diagnosis, management and, importantly, facilitation of timely escalation of care of conditions that can potentially affect the fetus.
OBJECTIVE
The aim of this article is to provide a diagnostic framework for approaching a pruritic rash during pregnancy as well as a helpful summary of management of pregnancy-specific dermatoses. It will assist clinicians in the identification of specific dermatoses that pose fetal risks.
DISCUSSION
In addition to considering non-pregnancy specific conditions when approaching pruritus or a pruritic rash in pregnancy, it is important that clinicians also consider pregnancy-specific dermatoses, which have been reclassified into four categories: polymorphic eruption of pregnancy, pemphigoid gestationis, intrahepatic cholestasis of pregnancy (ICP) and atopic eruption of pregnancy. Unlike the other dermatoses, ICP begins with pruritus, and skin changes are secondary. ICP and pemphigoid gestationis are associated with fetal risks such as prematurity and stillbirth.
Topics: Cholestasis, Intrahepatic; Female; Humans; Pemphigoid Gestationis; Pregnancy; Pregnancy Complications; Pruritus; Skin Diseases
PubMed: 34845477
DOI: 10.31128/AJGP-03-21-5900 -
Dermatology Research and Practice 2015Dermatoses unique to pregnancy are important to recognize for the clinician as they carry considerable morbidity for pregnant mothers and in some instances constitute a... (Review)
Review
Dermatological Diseases Associated with Pregnancy: Pemphigoid Gestationis, Polymorphic Eruption of Pregnancy, Intrahepatic Cholestasis of Pregnancy, and Atopic Eruption of Pregnancy.
Dermatoses unique to pregnancy are important to recognize for the clinician as they carry considerable morbidity for pregnant mothers and in some instances constitute a risk to the fetus. These diseases include pemphigoid gestationis, polymorphic eruption of pregnancy, intrahepatic cholestasis of pregnancy, and atopic eruption of pregnancy. This review discusses the pathogenesis, clinical importance, and management of the dermatoses of pregnancy.
PubMed: 26609305
DOI: 10.1155/2015/979635 -
JAMA Dermatology Feb 2022This case series characterizes immune profiles of pregnant people with pemphigoid gestationis.
This case series characterizes immune profiles of pregnant people with pemphigoid gestationis.
Topics: Autoantibodies; Autoantigens; Female; Humans; Non-Fibrillar Collagens; Pemphigoid Gestationis; Pemphigoid, Bullous; Pregnancy
PubMed: 34985500
DOI: 10.1001/jamadermatol.2021.5294 -
Nursing For Women's Health 2015Itching is commonly reported by pregnant women and may be due to physiologic changes of pregnancy or could indicate a more serious health concern. Intrahepatic...
Itching is commonly reported by pregnant women and may be due to physiologic changes of pregnancy or could indicate a more serious health concern. Intrahepatic cholestasis of pregnancy, while classified as a pregnancy dermatosis, is actually a liver disease of pregnancy associated with significant fetal mortality and morbidity, as well as lifelong health risks for the offspring. In these challenging cases, nurses must understand the differential diagnoses and be prepared to provide comprehensive care, education and support to women with this condition. A case example is included.
Topics: Adolescent; Adult; Cholestasis, Intrahepatic; Female; Humans; Middle Aged; Pemphigoid Gestationis; Pregnancy; Pregnancy Complications; Pruritus; Skin
PubMed: 25690815
DOI: 10.1111/1751-486X.12175 -
The Journal of Investigative Dermatology Dec 2016
Topics: Adult; Age Factors; Autoantibodies; Child; Electronic Health Records; Epidermolysis Bullosa Acquisita; Female; Germany; Humans; Incidence; Linear IgA Bullous Dermatosis; Male; Middle Aged; Pemphigoid Gestationis; Pemphigoid, Bullous; Pemphigus; Pregnancy; Prevalence
PubMed: 27456755
DOI: 10.1016/j.jid.2016.07.013 -
BMJ Case Reports Apr 2018Pemphigoid gestationis (PG), also known as , is a rare autoimmune blistering disease specific to pregnancy, which usually presents in the second or third trimesters and,...
Pemphigoid gestationis (PG), also known as , is a rare autoimmune blistering disease specific to pregnancy, which usually presents in the second or third trimesters and, in 15%-25% of cases, during the immediate postpartum period.Although the ethiopathogeny of PG is not fully clarified, most patients develop antibodies against a 180 kDa transmembrane hemidesmosomal protein (BP180; BPAG2; collagen XVII). PG has a strong association with human leucocyte antigens DR3 and DR4.We report a case of a 29-year-old female patient with PG successfully treated with intravenous immunoglobulin.
Topics: Adult; Female; Fluorescent Antibody Technique; Humans; Immunoglobulins, Intravenous; Pemphigoid Gestationis; Pregnancy; Pregnancy Outcome; Pregnancy Trimester, Third; Treatment Outcome
PubMed: 29627782
DOI: 10.1136/bcr-2018-224346 -
JAAD International Dec 2023
PubMed: 37786789
DOI: 10.1016/j.jdin.2023.08.015 -
PloS One 2021Autoimmune bullous diseases vary in their clinico-epidemiological features and burden across populations. Data about these diseases was lacking in Sudan. We aimed to...
OBJECTIVES
Autoimmune bullous diseases vary in their clinico-epidemiological features and burden across populations. Data about these diseases was lacking in Sudan. We aimed to describe the epidemiological profile and to estimate the burden of autoimmune bullous diseases in Sudan.
METHODS
This was a retrospective cross-sectional study conducted at Khartoum Dermatological and Venereal Diseases Teaching Hospital. We used routinely collected health care data, and included all patients with an autoimmune bullous disease who presented to the hospital between 2001 and 2016.
RESULTS
Out of the 4736 patients who were admitted to the hospital during the study period, 923 (19.5%) had an autoimmune bullous disease. The average rate of patients at the hospital was 57.7 per year representing 1.3 per 100,000 population per year. After exclusion of patients where the final diagnosis was missing, 585 were included in the further analysis. Pemphigus vulgaris was the most common disease (50.9%), followed by bullous pemphigoid (28.2%), linear IgA disease/chronic bullous disease of childhood (8.4%), and pemphigus foliaceous (8.2%). Pemphigoid gestationis and IgA pemphigus constituted 1.4% and 1.2% of the cohort, respectively. Paraneoplastic pemphigus, mucous membrane pemphigoid, lichen planus pemphigoidis, bullous systemic lupus erythematosus, and dermatitis herpetiformis were rare. None of the patients had epidermolysis bullosa acquisita.
CONCLUSIONS
The clinico-epidemiological characteristics vary among the types of autoimmune bullous diseases. Females were more predominant in most of them. Sudanese patients tended in general to present at a younger age than other populations. The pool of Sudanese patients with autoimmune bullous diseases is large which requires investigation for the local risk factors and presents a field for future trials.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Autoimmune Diseases; Child; Child, Preschool; Cross-Sectional Studies; Epidermolysis Bullosa Acquisita; Female; Humans; Male; Middle Aged; Pemphigoid, Benign Mucous Membrane; Pemphigoid, Bullous; Retrospective Studies; Sudan; Young Adult
PubMed: 34255799
DOI: 10.1371/journal.pone.0254634 -
Indian Dermatology Online Journal 2020
PubMed: 33344355
DOI: 10.4103/idoj.IDOJ_93_20 -
BMJ Case Reports Mar 2021Pemphigoid gestationis is a rare autoimmune subepidermal bullous dermatosis occurring during pregnancy and post partum. A 32-year-old woman developed itchy urticarial...
Pemphigoid gestationis is a rare autoimmune subepidermal bullous dermatosis occurring during pregnancy and post partum. A 32-year-old woman developed itchy urticarial wheals over the trunk and extremities at 6 months of gestation. This was not controlled with antihistamines, and 2 months later, the patient developed multiple vesiculobullous lesions. The patient had an exacerbation 3 weeks post-delivery. She did not go into remission for 6 months post partum despite treatment with prednisolone 40 mg/day, doxycycline 100 mg two times per day and dapsone 100 mg/day. The patient went into remission following treatment with three courses of intravenous immunoglobulin 2 mg/kg/course and 2 doses of rituximab 1 g at a 2-week interval.
Topics: Adult; Female; Humans; Immunoglobulins, Intravenous; Pemphigoid Gestationis; Postpartum Period; Pregnancy; Rituximab; Skin Diseases, Vesiculobullous
PubMed: 33727302
DOI: 10.1136/bcr-2020-241496