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Dermatoses of Pregnancy

Specific Dermatoses of Pregnancy

»Name four pregnancy-specific dermatological disorders
»What is pruritic urticarial papules and plaques of pregnancy?
»Does PUPPP have any associated morbidity?
»How is PUPPP treated?
»From which dermatosis of pregnancy must PUPPP be differentiated?
»What is pemphigoid gestationis?
»What are the antigens associated with the development on pemphigoid gestationis?
»Which histocompatibility leukocyte antigen (HLA) types have been associated with pemphigoid gestationis?
»Compare PUPPP and pemphigoid gestationis.
»What is atopic eruption of pregnancy?
»What is intrahepatic cholestasis of pregnancy?
»What is the epidemiology of ICP?
»Are there specific laboratory findings to establish the diagnosis?
»What risks and outcomes are associated with intrahepatic cholestasis of pregnancy?
»How is cholestasis of pregnancy treated?
»Is impetigo herpetiformis a distinct clinical disease?
»Are there lab findings associated with impetigo herpetiformis?
»What is the treatment for impetigo herpetiformis?

Physiologic Skin Changes in Pregnancy

»List the physiologic skin changes that can occur as a normal part of pregnancy.
»What are some of the normal pigmentary changes that can be associated with pregnancy?
»Why do these pigmentary changes occur?
»How does pregnancy affect patients with melanoma?
»Is pregnancy associated with changes in hair growth?
»List the vascular changes that can occur in pregnancy.
»What factors influence the development of striae distensae (commonly known as “stretch marks”)?
»Discuss two cutaneous tumors often associated with pregnancy.
»Do some diseases improve with pregnancy?
»Do some mucocutaneous diseases worsen in pregnancy?

 
 
 

What risks and outcomes are associated with intrahepatic cholestasis of pregnancy?

The main risks are to the fetus; the fetus is unable to excrete cholic acid, resulting in toxicity. Sudden intrauterine fetal death occurs in 1% to 2% of pregnancies affected by ICP. Other complications include respiratory distress syndrome, meconium staining of amniotic fluid membranes, and premature delivery. The risk of fetal complications increases with bile acids levels >40 µM/L. There are not usually any long-term maternal sequelae. The pruritus associated with ICP usually resolves within 48 hours to 2 weeks, after delivery.

Hepburn I: Pregnancy-associated liver disorders, Dig Dis Sci (53):2334–2358, 2008.