Pregnancy Dermatoses

Abstract

BACKGROUND Pregnancy is a physiological status of a woman. Every organ is adapting in order to accept another human body. The main changes occur in the endocrine, immune, metabolic and vascular systems. The skin is no exception. Many skin changes during pregnancy are considered to be normal or physiological including striae gravidarum or melasma. These physiological skin changes are usually well tolerated by the pregnant woman. There is no balance between these systems, however, and abnormalities can appear. Immunologic status of the woman plays an important role in the manifestations exhibited in the skin. Alterations of the skin during pregnancy can be classified as physiologic skin changes, changes in pre-existing skin diseases and specific dermatoses of pregnancy. MATERIALS AND METHODS 200 pregnant women with skin manifestations attending Dermatology and Obstetric departments attached to Government General Hospital, Kurnool, were studied. 1. A detailed proforma was taken, which included: a. Detailed history including chief complaints related to skin. b. Onset in relation to duration of pregnancy. c. Complete general physical and systemic examination. d. Associated skin/medical disorders. 2. Investigations-CBP, CUE, RBS, LFT, HBsAg, VDRL, HIV 1 and 2 were done routinely. 3. KOH mount, saline mount and skin biopsy performed wherever required. Inclusion criteria-All pregnant women having skin lesions were included in the study irrespective of the duration of pregnancy and gravidity. Exclusion criteria-Pregnant women having any underlying medical diseases. All pregnant women attending antenatal OPD and those admitted into wards having symptoms related to skin and mucosa, at KIMS Hospital are studied. 1. Detailed history including chief complaints related to skin. 2. Onset in relation to duration of pregnancy. 3. Complete general physical and systemic examination. 4. Associated skin/medical disorders. 5. Investigations-CBP, CUE, RBS, LFT, HBsAg, VDRL, HIV 1 and 2 were done routinely. KOH mount and skin biopsy performed wherever required. 6. Proforma used to record the above information. RESULTS In this study, a total number of 200 women were enrolled. Pigmentation of the skin was the commonest change observed in 96% of the cases. Striae were observed in 99.1% of multipara women on abdomen where as they were observed in 89.2% of primies. Specific dermatoses of pregnancy were found in 11 out of 200 patients (5.5%). Pruritus gravidarum is the most frequent dermatosis occurring 4 out of 11 patients (36.36%). Prurigo gestationis was observed in 3 out of 11 patients (27.2%). Polymorphic eruption of pregnancy was observed in 2 out of 11 patients (18.8%). Among 200 patients examined, 42 diseases were diagnosed with respect to Dermatology, Leprology and Venereology in 134 patients. CONCLUSION This study emphasises the need for a scrupulous and meticulous search for dermatological and sexually transmitted disease instead of routine regular antenatal checkups and dismissing the patients with symptoms attributing them to the ...