Abstract | Dermatoses of pregnancy are heterogenous group of dermatoses that occur exclusively during the pregnancy or immediate postpartum period. Pregnancy results in cutaneous changes in more than 90% of women. Cutaneous changes are usually so well recognized that some constitute contributory evidence of pregnancy. Most changes occur as a physiological adaptation to pregnancy and are often considered benign or of cosmetic concern only, while a minority may be an important sign to recognize as they may signify or lead to serious morbidity and complications in the gravid patient and, in some cases, in the fetus. Specific etiologies are various and most often relate to changes in the gravid female's hormonal, metabolic, and immunological processes.
This comprehensive review of the existing literature emphasizes the importance of early detection, diagnosis and treatment of the dermatoses of pregnancy, and is aimed at helping physicians to recognize, diagnose, manage, and treat these rare, yet potentially life-threatening, conditions. Only some dermatoses are associated with fetal and maternal risks; these are the more common Pemphigoid gestationis (PG), and Intrahepatic cholestasis of pregnancy (ICP) and the much rarer Pustular psoriasis of pregnancy (PPP), but nevertheless there is a necessity to be familiarized with all dermatoses of pregnancy stemming from the fact that the symptoms are highly overlapping between the diseases.
In all cases, a pregnant woman with a pruritic skin eruption requires immediate evaluation and treatment to avoid delayed or misdiagnosis. Interdisciplinary management involving dermatologists, pediatricians, obstetricians, and (in relevant cases) gastroenterologists is mandatory to acquire a better outcome for the mother and the fetus. |
Abstract (croatian) | Dermatoze u trudnoći su heterogena skupina dermatoza koje se javljaju isključivo tijekom trudnoće ili neposredno nakon poroda. U trudnoći se kožne promjene pojavljuju u više od 90% žena. Promjene na koži obično se tako karakteristične da neke od njih predstavljaju znak trudnoće. Većina promjena predstavlja fiziološku prilagodbu na trudnoću i često se smatraju benignima ili samo kozmetičkim problemom, dok manji broj bolesti je iznimno važno prepoznati jer mogu dovesti do ozbiljnog morbiditeta i komplikacija kod trudnica, a u nekim slučajevima i kod ploda. Etiologija pojedinih bolesti je različita te se najčešće smatraju posljedicom promjena u hormonalnim metaboličkim i imunološkim procesima u trudnice.
U ovom preglednom radu prikazani su podatci iz literature te je naglašena važnost ranog otkrivanja, dijagnoze i liječenja dermatoza u trudnoći. Cilj rada je pomoći liječnicima da prepoznaju, dijagnosticiraju, i liječe ove rijetka, ali potencijalno po život opasne bolesti. Neke od opisanih dermatoza povezane su i s rizicima za plod; to su najčešće gestacijski pemfigoid, intrahepatalna kolestaza u trudnoći te znatno rjeđe pustulozna psorijaza u trudnoći.
U svim slučajevima u Kojima trudnica ima izraženi svrbež s promjenama na koži potreban je hitan pregled liječnika, dijagnostički postupak i liječenje kako bi se izbjegla kasna ili pogrešna dijagnoza. Interdisciplinarno liječenje koje uključuje dermatologe, pedijatre, opstetričare i (u relevantnim slučajevima) gastroenterologe je obavezno kako bi se postigao bolji ishod za majku i plod. |