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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 -
Clinics in Dermatology 2022Annular bullous dermatoses represent an etiologically diverse group of cutaneous phenomena that present with a figurate morphology in association with vesicles and... (Review)
Review
Annular bullous dermatoses represent an etiologically diverse group of cutaneous phenomena that present with a figurate morphology in association with vesicles and bullae. This group of diverse conditions consists of bullous pemphigoid; pemphigoid gestationis; epidermolysis bullosa simplex, Dowling-Meara type; linear immunoglobulin A bullous dermatosis; chronic bullous disease of childhood; anti-p200 pemphigoid; subcorneal pustular dermatosis; and immunoglobulin A pemphigus. Astute examination of clinical, histopathologic, and serologic features is crucial in distinguishing these bullous dermatoses. We review the clinical presentation, pathophysiology, histopathology, and treatments for each bullous annular disease to aid physicians in their recognition, diagnosis, and management.
Topics: Humans; Skin Diseases, Vesiculobullous; Pemphigoid, Bullous; Pemphigus; Linear IgA Bullous Dermatosis; Blister; Immunoglobulin A; Autoimmune Diseases
PubMed: 34979265
DOI: 10.1016/j.clindermatol.2021.12.012 -
Medicina Clinica Apr 2020
Topics: Female; Humans; Pemphigoid Gestationis; Pemphigoid, Bullous; Pregnancy; Pregnancy Complications
PubMed: 31506200
DOI: 10.1016/j.medcli.2019.05.037 -
The New England Journal of Medicine Aug 2020
Topics: Adult; Biopsy; Complement C3; Female; Humans; Immunoglobulin Isotypes; Pemphigoid Gestationis; Pregnancy; Skin
PubMed: 32846065
DOI: 10.1056/NEJMicm2000922 -
American Family Physician Feb 2023Skin conditions during pregnancy fall into three categories: benign hormone-related changes, preexisting skin conditions, and pregnancy-specific disorders. Benign...
Skin conditions during pregnancy fall into three categories: benign hormone-related changes, preexisting skin conditions, and pregnancy-specific disorders. Benign hormonal skin changes (e.g., hyperpigmentation, striae gravidarum, hair and nail changes, vascular changes) are common during pregnancy and often improve or resolve postpartum. Topical therapies, including tretinoin, hydroquinone, and corticosteroids, can be helpful in the postpartum treatment of melasma. The severity of preexisting skin conditions such as acne vulgaris, condylomata acuminata, herpes simplex, hidradenitis suppurativa, and psoriasis varies during pregnancy. Treatment options for chronic skin conditions during pregnancy often differ from usual practice because of safety concerns. Discussion of potential risks and benefits is important. Low- to midpotency topical corticosteroids are generally considered safe during pregnancy, whereas extensive use of high-potency corticosteroids may be associated with low birth weight. Pregnancy-specific skin conditions include atopic eruption of pregnancy, polymorphic eruption of pregnancy, pemphigoid gestationis, intrahepatic cholestasis of pregnancy, and pustular psoriasis of pregnancy. Conditions that may cause adverse fetal outcomes and require consideration of antenatal fetal surveillance include intrahepatic cholestasis of pregnancy, pemphigoid gestationis, and pustular psoriasis of pregnancy.
Topics: Female; Pregnancy; Humans; Pemphigoid Gestationis; Pregnancy Complications; Skin; Psoriasis; Skin Diseases, Vesiculobullous; Exanthema
PubMed: 36791447
DOI: No ID Found -
Revue Medicale Suisse Mar 2022Pregnancy has a substantial impact on the hormonal status of the organism, consequently influencing the physiology of the skin. This results in dermatoses that only...
Pregnancy has a substantial impact on the hormonal status of the organism, consequently influencing the physiology of the skin. This results in dermatoses that only occur during pregnancy, which can also improve or exacerbate pre-existing dermatoses. In this article, we explain the management of pregnancy-specific dermatoses : atopic eruption of pregnancy, polymorphic eruption of pregnancy, pemphigoid gestationis, impetigo herpetiformis, and intrahepatic cholestasis of pregnancy. It is essential to clearly distinguish these different dermatoses as some of them, such as pemphigoid gestationis, impetigo herpetiformis and intrahepatic cholestasis of pregnancy, can have fetal consequences and as result, need to be closely monitored by the obstetricians.
Topics: Cholestasis, Intrahepatic; Female; Humans; Pemphigoid Gestationis; Pregnancy; Pregnancy Complications; Skin; Skin Diseases
PubMed: 35353455
DOI: 10.53738/REVMED.2022.18.775.596 -
Obstetrics and Gynecology Oct 2022Pregnancy dermatoses are inflammatory skin disorders that occur during pregnancy or immediately postpartum. This heterogenous group of disorders includes pemphigoid... (Review)
Review
Pregnancy dermatoses are inflammatory skin disorders that occur during pregnancy or immediately postpartum. This heterogenous group of disorders includes pemphigoid gestationis, polymorphic eruption of pregnancy, intrahepatic cholestasis of pregnancy, atopic eruption of pregnancy, and pustular psoriasis of pregnancy. In this article, we provide a comprehensive literature review of each condition focusing on nomenclature, epidemiology, pathogenesis, clinical presentation, diagnosis, differential diagnosis, maternal risk, fetal risk, and treatment. We aim to increase awareness and help clinicians recognize, diagnose, and manage these unique conditions.
Topics: Female; Pregnancy; Humans; Pregnancy Complications; Pemphigoid Gestationis; Cholestasis, Intrahepatic; Skin Diseases; Diagnosis, Differential; Pruritus
PubMed: 36075066
DOI: 10.1097/AOG.0000000000004938 -
Frontiers in Immunology 2024Autoimmune blistering disorders (AIBDs) are a heterogeneous group of approximately a dozen entities comprising pemphigus and pemphigoid disorders and dermatitis... (Review)
Review
Autoimmune blistering disorders (AIBDs) are a heterogeneous group of approximately a dozen entities comprising pemphigus and pemphigoid disorders and dermatitis herpetiformis. The exact diagnosis of AIBDs is critical for both prognosis and treatment and is based on the clinical appearance combined with the detection of tissue-bound and circulating autoantibodies. While blisters and erosions on the skin and/or inspectable mucosal surfaces are typical, lesions may be highly variable with erythematous, urticarial, prurigo-like, or eczematous manifestations. While direct immunofluorescence microscopy (IFM) of a perilesional biopsy is still the diagnostic gold standard, the molecular identification of the major target antigens opened novel therapeutic avenues. At present, most AIBDs can be diagnosed by the detection of autoantigen-specific serum antibodies by enzyme-linked immunosorbent assay (ELISA) or indirect IFM when the clinical picture is known. This is achieved by easily available and highly specific and sensitive assays employing recombinant immunodominant fragments of the major target antigens, i.e., desmoglein 1 (for pemphigus foliaceus), desmoglein 3 (for pemphigus vulgaris), envoplakin (for paraneoplastic pemphigus), BP180/type XVII collagen (for bullous pemphigoid, pemphigoid gestationis, and mucous membrane pemphigoid), laminin 332 (for mucous membrane pemphigoid), laminin β4 (for anti-p200 pemphigoid), type VII collagen (for epidermolysis bullosa acquisita and mucous membrane pemphigoid), and transglutaminase 3 (for dermatitis herpetiformis). Indirect IFM on tissue substrates and in-house ELISA and immunoblot tests are required to detect autoantibodies in some AIBD patients including those with linear IgA disease. Here, a straightforward modern approach to diagnosing AIBDs is presented including diagnostic criteria according to national and international guidelines supplemented by long-term in-house expertise.
Topics: Humans; Autoantibodies; Autoimmune Diseases; Autoantigens; Skin Diseases, Vesiculobullous; Enzyme-Linked Immunosorbent Assay
PubMed: 38903493
DOI: 10.3389/fimmu.2024.1363032