Safety of topical corticosteroids in pregnancy

Chi, Ching‐Chi; Wang, Shuhui; Wojnarowska, Fenella; Kirtschig, Gudula; Davies, Emily; Bennett, Cathy

doi:10.1002/14651858.cd007346.pub3

Cited by 76 publications

(44 citation statements)

References 56 publications

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“…Overall, the level of evidence was classified by the authors as 'very low' since all studies were observational, and variation observed in the results of the included studies was high. 48 In conclusion, several studies have examined the risk of TCS use in pregnancy, and overall, it has been deemed safe, although the use of very potent topical corticosteroids may be associated with low birthweight. There is an exception, though fluticasone propionate is the only TCS that is known not to be metabolized by the placenta and therefore should not be used in pregnant women.…”

Section: Menmentioning

confidence: 99%

European task force on atopic dermatitis position paper: treatment of parental atopic dermatitis during preconception, pregnancy and lactation period

Vestergaard

Wollenberg

Barbarot

et al. 2019

Acad Dermatol Venereol

173

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Atopic dermatitis (AD) is a common inflammatory skin disease that affects both children and adults, including a large number of adults of reproductive age. Several guidelines for the treatment of AD exist, yet specific recommendations for the treatment of pregnant or lactating women and for adults planning to have a child are often lacking. This position paper from the European Task force on Atopic Dermatitis (ETFAD) is based on up‐to‐date scientific literature on treating pregnant and lactating women as wells as adults with AD planning to have a child. It is based on the expert opinions of members of the ETFAD and on existing safety data on the proposed treatments, many of which are derived from patients with other inflammatory diseases or from transplantation medicine. For treating future parents, as well as pregnant and lactating women with AD, the use of topical treatments including moisturizers, topical corticosteroids, tacrolimus, antiseptics such as chlorhexidine, octenidine, potassium permanganate and sodium hypochlorite (bleach) is deemed to be safe. Ultraviolet (UV) therapy may also be used. Systemic treatment should be prescribed only after careful consideration. According to the opinion of the ETFAD, treatment should be restricted to systemic corticosteroids and cyclosporine A, and, in selected cases, azathioprine.

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Section: Menmentioning

confidence: 99%

European task force on atopic dermatitis position paper: treatment of parental atopic dermatitis during preconception, pregnancy and lactation period

Vestergaard

Wollenberg

Barbarot

et al. 2019

Acad Dermatol Venereol

173

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“…Mid-to high-potency topical corticosteroids could be used once or twice a day as adjuvant therapy in localized form of disease (Serrano-Falcon & Serrano-Falcon, 2010). Several observational studies and metaanalyses asses the safety of topical corticosteroid use during pregnancy (Chi et al 2015;Chi, Wang, & Kirtschig, 2016). However, an increased risk of low birth weight was reported when exceeding 300 g of a potent or superpotent topical corticosteroids during the whole pregnancy (Chi, Wang, Mayon-White, & Wojnarowska, 2013).…”

Section: Discussion An D Con Cl Usion Smentioning

confidence: 99%

Treatment of Sweet's syndrome in pregnancy

Corbeddu

Pilloni

Pinna

et al. 2018

Dermatologic Therapy

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Pregnancy-associated Sweet's syndrome is a rare occurrence (2%), with good prognosis, spontaneous resolution after delivery, and not increased infant morbidity and mortality. However, differential diagnosis is not easy for physician not familiar with skin lesions. Systemic involvement, even though unusual, might occur in nearly every organ of the body, including pericardium, myocardium, and placenta, as well as one report of early fetal miscarriage, questioning the possibility of risks underestimation. We present two further cases, one occurred in a 31-year-old woman at 26 weeks of gestation and the other on a 26-year-old woman at 24 weeks of gestation, primigravidae. Both presented with tender papules and nodules on their face and upper body parts. Laboratory examinations and skin biopsy histology were pathognomonic. Monitoring of general maternal and fetal conditions showed no signs of sufferance, but the decision to accelerate skin symptoms release, being time to delivery quite distant, challenge the treatment options. There are no recommended treatments for Sweet syndrome and the choice is very limited during pregnancy. A short course of oral steroids was very effective, with lesions healing in few days, no relapses or fetal complications. When pregnant patients exhibit fever, neutrophilia, arthralgia or myalgia, and tender erythematous plaques or nodules, Sweet syndrome should be considered. The trained dermatologist is in the leading position to address the differential diagnosis, reassure the patient, and avoid complications, even if they are rare.

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“…An updated Cochrane Review evaluated the effect of TCS use on pregnancy outcomes, with a total of 1 601 515 patients. Most studies found no causal associations between maternal exposure to TCS and adverse pregnancy outcomes.…”

Section: Treatment Of Atopic Eczemamentioning

confidence: 99%

What's new in atopic eczema? An analysis of systematic reviews published in 2015. Part 2: prevention and treatment

et al. 2018

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This review forms part of a series of annual updates that summarize the evidence base for atopic eczema (AE), providing a succinct guide for clinicians and patients. It provides a summary of key findings from 26 systematic reviews that were published during 2015, and focuses on the treatment and prevention of AE. For systematic reviews on the epidemiology and methodological issues, see Part 1 of this update. Topical corticosteroid withdrawal syndrome, 'steroid addiction', has been evaluated in a high-quality systematic review, which helps better define this entity and the risk factors for it. A Cochrane Review has not demonstrated any association between topical corticosteroid use in pregnancy and adverse outcomes, although very large quantities of potent/very potent topical corticosteroids may be associated with reduced birth weight. House dust mite avoidance strategies do not appear to prevent AE. Exposure to probiotics prenatally and in early infancy may help prevent AE, but there is no evidence that maternal diet or supplementation has a preventative effect.

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Safety of topical corticosteroids in pregnancy

Cited by 76 publications

References 56 publications

European task force on atopic dermatitis position paper: treatment of parental atopic dermatitis during preconception, pregnancy and lactation period

European task force on atopic dermatitis position paper: treatment of parental atopic dermatitis during preconception, pregnancy and lactation period

Treatment of Sweet's syndrome in pregnancy

What's new in atopic eczema? An analysis of systematic reviews published in 2015. Part 2: prevention and treatment

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