Dermatosis En El Embarazo

Table. Dermatoses in Pregnancy
Rate of Incidence
Pemphigoid Gestations Varies: US - 1:50,0002 UK – 1:40,0003

Appearance During Gestation
2nd or 3rd trimester; rarely during 1st trimester orpostpartum

Clinical Features
Pruritus, then erythematous urticarial papules, then plaques Generalized pemphigoid-like pattern

Localization
Abdomen, almost always within or near umbilicusAtypically, lesions involve limbs, palms, or soles

Diagnostic Tests
DIF/IIF: Positive linear deposition of C3 (100%) +/- IgG (30% of cases) along the BMZ Histopathology: +/- subepidermal blisteringTreatment and Management
If mild (preblistering): Topical corticosteroids plus emollients with or without oral antihistamines such as loratadine and cetirizine If blistering: Systemic corticosteroids(prednisolone; 0.5-1 mg/kg/d Self-limited, symptomatic treatment with topical corticosteroids such as mometasone, halcinonide, betamethasone valerate 0.1% applied twice daily, plus topicalantipruritic medication (menthol, polidocanol, or pramoxine) or emollient bath additives Systemic antihistamines can be added such as loratadine or cetirizine Off-label: Ursodeoxycholic acid 15 mg/kg/d or 1 g/d;single daily dose or divided into 2-3 doses

Maternal Prognosis
Generally improves in 3rd trimester and flares up at delivery Recurs in subsequent pregnancies, with earlier onset and increasedseverity

Fetal Prognosis
May develop mild clinical picture consisting of urticarial or vesicular skin lesions (Rare) Small-forgestational-age and prematurity Adrenal insufficiency

Late-OnsetPolymorphic Eruption of Pregnancy

1:16015

3rd trimester or postpartum

Small urticarial papules that coalesce into erythematous plaques Later: Polymorphous features such as papulovesicles ormicrovesicles, urticarial lesions, target lesions, annular or polycyclic wheals, small bullae (rare)

Abdomen, within and/or adjacent to striae; does not affect umbilical region Buttocks Proximal thighs...