A clinical study of skin disorders in pregnancy

Abstract

INTRODUCTIONVarious physiological adaptation of pregnancy related, immunological, metabolic, endocrine and vascular changes occurs during pregnancy which make the pregnant women susceptible to changes of skin and appendages.1 These changes can be categorised in three categories. First include various benign skin conditions due to physiological and hormonal changes like striae gravidarum, melasma, nail and vascular changes. Pre-existing skin conditions which flare-up during pregnancy included in second category. Third category have several pregnancy specific dermatoses.2 Pregnancyspecific dermatoses is a heterogeneous group of pruritic skin diseases unique to pregnancy. Ambrus-Rudolph proposed the latest classification of pregnancy-specific dermatoses in 2006 and includes pemphigoid gestationis (PG), polymorphic eruption of pregnancy (PEP), intrahepatic cholestasis of pregnancy (ICP), and atopic eruption of pregnancy (AEP).3 Most of these skin ABSTRACT Background: Various physiological adaptation of pregnancy related, immunological, metabolic, endocrine and vascular changes occurs during pregnancy which make the pregnant women susceptible to changes of skin and appendages to study the various cutaneous changes of pregnancy. Methods: This study was an observational cross-sectional study conducted in Obstetrics and Gynaecology Department at Umaid Hospital and Skin Department at MDM Hospital, Jodhpur. Total number of 200 pregnant females were included in this study after informed consent and ethical committee clearance in duration of 6 months. Detailed medical and obstetric history of patients were obtained, and physical and dermatological examination were performed. Relevant systemic examination and appropriate investigations were done to confirm diagnosis if required.Results: Most of patients show cutaneous changes, among them physiological changes were most common 196 (98%). The most common physiological change was hyperpigmentation, which was seen in 189 (94.49%) cases followed by striae distensae (76.5%), glandular changes (11.5%) and vascular (9%). Tinea cruris was noted in 04 cases (2%) while scabies was present in 10 females (5%). 15 (7.5%) cases of contact dermatitis were noticed, and psoriasis was found in 3 (1.5%) pregnant females. Herpes genitalis was seen in 1 case (0.5%). The most common Specific dermatoses was pruritic urticarial papules and plaques of pregnancy 10, (5%) followed by pruritic folliculitis 4 (2%), eczema 4 (2%) and intrahepatic cholestsis of pregnancy 2 (1%). Conclusions: Pregnant women are prone to various cutaneous manifestation during pregnancy. A detailed history and awareness of clinical presentation is helpful for confirmation of diagnosis and most appropriate laboratory evaluation is helpful to diminish the maternal and foetal morbidity.

Clinical study of pregnancy associated cutaneous changes

“…~ 74 ~ Among the physiological changes, hyperpigmentation was commonest with linea nigra the most common pattern in 82% of the patients which is similar to study by Kumari et al [9] and Meena et al [13] where the most common pattern of hyperpigmentation was reported to be linea nigra in 91.4% and 88.5% of the patients respectively. Pigmentary changes predominated in second and third trimester because of surge of estrogen and progesterone, which are strong melanogenic stimulants, late in the pregnancy.…”

Women’s Health: Most Common Physiologic and Pathologic Cutaneous Manifestations During Pregnancy

“…This systematic review included 11 articles that met the eligibility criteria and were published between 2015 and 2021 (Table 1) [8][9][10][11][12][13][14][15][16][17][18]. In regard to the study designs of included articles, there were two cross-sectional studies [14,18], three cross-sectional were observational studies [10,16,17], one observational [8], one prospective observational cohort [9], one retrospective [11], and one prospective [13] whereas one study did not specify the design [12]. The total number of participants in the 11 studies was 14,813 participants, the least number of subjects included in a study was 100 pregnant women [12], and the largest number included was 9,679 [8].…”

“…The total number of participants in the 11 studies was 14,813 participants, the least number of subjects included in a study was 100 pregnant women [12], and the largest number included was 9,679 [8]. The included studies were conducted in only four countries; one study in Nigeria [9], one study in Libya [13], one study in Brazil [18], whereas the remaining eight studies were all in India [8,[10][11][12][15][16][17]. The overall major dermatological conditions during pregnancy were physiological skin changes [11][12][13][14][15][16][17][18] and pregnancy-specific dermatopathologies [8,9].…”

“…The included studies were conducted in only four countries; one study in Nigeria [9], one study in Libya [13], one study in Brazil [18], whereas the remaining eight studies were all in India [8,[10][11][12][15][16][17]. The overall major dermatological conditions during pregnancy were physiological skin changes [11][12][13][14][15][16][17][18] and pregnancy-specific dermatopathologies [8,9]. However, only one study reported that STDs and other infectious skin disorders were the major presenting dermatosis during pregnancy [10].…”

“…Physiological skin changes are the predominantly recognized dermatologic manifestations of pregnancy as eight studies reported [11][12][13][14][15][16][17][18], three of which discovered that all included pregnant women had physiological skin changes [12,14,15]. On the other hand, these physiological changes varied in prevalence in two different studies, which showed a range of 17% [13] to 99% [17].…”