Papular Dermatitis of Pregnancy

Abstract

A generalized eruption, characterized by widely scattered, intensely itching, erythematous papules, that occur only during pregnancy is described. Among the 12 patients reported, there were 37

Dermatoses of Pregnancy - Clues to Diagnosis, Fetal Risk and Therapy

“…He differentiated a papular dermatitis from prurigo gestationis, which is clinically similar, on the grounds of biochemical alterations (raised levels of β-HCG in urine, lowered plasma cortisol levels) and reported a dramatically increased fetal death rate (early miscarriage and miscarriage in previous pregnancies were included! )11. In over 40 years, with the exception of one further case report by the same authors, no further case corresponding to the original description has surfaced.…”

Skin disorders in pregnancy

“…However, the feature which Spangler et al felt was of particular importance was the high level of urinary human chorionic gonadotrophin (hGC) during the last trimester which returned to normal following treatment with systemic corticosteroids. 23 The authors also noted reduced plasma hydrocortisone and a shortened plasma hydrocortisone half-life in their group of patients. No histopathological data was recorded in patients reported by Spangler et al 32 so that no clinico-pathological correlation is possible in retrospect.…”

“…Spangler and colleagues felt this condition could be differentiated from prurigo of pregnancy both clinically and biochemically. 23 On clinical grounds the lesions were diffusely scattered and the pruritus was unresponsive to topical therapy, whereas in prurigo gestationis of Besnier 66 the lesions were often clustered on the limbs and the pruritus invariably responded to topical therapy. However, the feature which Spangler et al felt was of particular importance was the high level of urinary human chorionic gonadotrophin (hGC) during the last trimester which returned to normal following treatment with systemic corticosteroids.…”

“…23 It was calculated that, in the absence of treatment, the fetal mortality was 27%, whereas in the eleven cases out of twelve treated with corticosteroids there was no fetal loss. However, the authors did not specify whether the fetal losses were the result of stillbirths or spontaneous abortions.…”

“…Papular dermatitis of pregnancy as described by Spangler et al is not included in this classi®cation and is now thought to overlap with prurigo and Polymorphic eruption of pregnancy (PEP) and not to be a separate clinical entity. 23 So far in published data only one recent prospective study of ®fty one women has been performed to examine the incidence of these disorders in a pregnant population. 24 …”