A Screening Study on Dermatoses in Pregnancy

Abstract

INTRODUCTIONPregnancy, an endocrine storm, is characterized by altered endocrine, metabolic, and immunologic milieus. These alterations result in both multiple physiologic and pathologic cutaneous changes that may range from normal cutaneous changes to eruptions that appear to be specifically associated with pregnancy [1]. Moreover, pregnancy may modify the course of a number of dermatological conditions. The present study was undertaken to find out the prevalence of the physiological and pathological skin changes -specific dermatoses of pregnancy, various infective and miscellaneous cutaneous diseases in pregnancy and to correlate the prevalence of the major cutaneous changes and diseases in relation to different trimesters of pregnancy and with gravidity. MATERIALS AND METHODSA cross-sectional study was conducted during the period of August 2008 to August 2010. Ethical clearance was sought from Institutional Ethical Committee. After acquiring informed consent, about 500 pregnant women who attended the Outpatient Department of Maternity Hospital, Madras Medical College, Chennai, Tamil Nadu, India during the time period were randomly selected, irrespective of the duration of pregnancy and gravidity. Pregnant women in active labour were excluded from the study. Detailed history and complete dermatological examination was done in all cases to study the physiological and pathological changes of skin and its appendages. Relevant systemic examination and investigations like KOH mount, Gram's stain, Tzanck smear, and liver function test were done if required to confirm the diagnosis. Venereal Disease Research Laboratory (VDRL) and enzyme linked immune sorbent assay for Human Immunodeficiency Virus (HIV) were done in all the cases. Results were tabulated and analysed. STATISTICAL ANALySISStatistical analysis of major cutaneous changes between primigravidas and multigravidas, and between various trimesters was done by Fisher's-exact test and Chi-square test. Statistical analysis was done using software SPSS version 16. A p-value less than 0.05 were considered significant. RESULTSA total of 500 pregnant women were studied from August 2008 to August 2010. Of these, 291 (58.2%) were primigravidas, 209 (41.8%) were multigravidas. Among the multigravidas, 164 (32.8%) were second gravida, 39 (7.8%) were third gravida, and six (1.2%) were fourth gravida. Cases seen in the I st trimester were nine (1.8%), II nd trimester were 87 (17.4%) and III rd trimester were 404 (80.8%).The distribution of physiological skin changes observed during pregnancy (n =500) is shown in [ ABSTRACTIntroduction: Pregnancy produces many cutaneous changes, some of which are specifically related to pregnancy (dermatoses of pregnancy), some are modifiable by pregnancy and others that are common are named physiologic. These physiologic skin changes, usually do not impair the health of the mother or the fetus but some of them can be cosmetically significant and of importance to the dermatologist.

Pattern of Pregnancy Dermatoses among Antenatal Mothers in Government Vellore Medical College

“…Other conditions such as scabies, Taenia Cruris, Miliaria, and Intertrigo etc were coexisting in pregnant mothers. Similar skin conditions in pregnancy were found in many studies 2,3 . The disease conditions might occur coincidentally or sometimes as increased glandular functions, raised levels of estrogen etc.…”

Skin changes during pregnancy. Is that an important issue for pregnant women?

“…Increased prevalence of pigmentary changes during pregnancy is related to increased alpha-melanocyte stimulating hormone plasma concentration as well as melanocytic stimulation caused by estrogens and progesteron [10]. Kannambal et al [1] reported pigmentary changes in 90.8%, Fernandes et al [7] observed hyperpigmentation in 87,95% of cases, Panicker et al [6] reported hyperpigmentation in 87.6% of the studied women. In our group it is difficult to refer to the incidence of pigmentary changes because none of the interviewed women reported discoloration as a skin problem.…”

“…Pregnancy is a life period connected with various and intensive endocrine, metabolic, immunological and vascular changes in women's bodies. Regarding the skin, these conditions may range from physiological changes, common skin diseases not associated with pregnancy, to pathologic eruptions specially associated with pregnancy [1].…”

“…Available studies show wide variations and conflicting data in the incidence of specific pregnancy dermatoses depending on the regions of the world [1,4,6].…”

Características demográficas, sociais e clínicas de mulheres em idade fértil atingidas pela Hanseníase

“…Desta forma, estas necessitam de atenção por parte dos profissionais de saúde, visto que, esta enfermidade se não for diagnosticada e tratada precocemente leva as incapacidades físicas. [7][8] Diante dos fatos, o presente estudo teve como questão norteadora: quais as características demográficas, sociais e clínicas de mulheres em idade fértil atingidas pela hanseníase em uma capital do nordeste brasileiro? As pesquisas vêm apontando um maior número de casos em mulheres na faixa etária reprodutiva.…”