Dermatological changes in pregnancy in central India: a cross sectional study

Abstract

<p class="abstract"><strong>Background:</strong> Pregnancy is a period of profound endocrine and metabolic alterations which make the pregnant woman susceptible to changes in the skin and its appendages. These changes in pregnancy can be either physiological, development of pregnancy specific dermatoses or changes in pre-existing skin diseases. The aim of the study to study the dermatological manifestations of pregnancy.</p><p class="abstract"><strong>Methods:</strong> This was a cross sectional study design. All pregnant females with cutaneous manifestations attending outpatient department of Dermato-Venereo-Leprology and Obstetrics and Gynaecology were recruited during December 2015 to October 2017. They were subjected to general, local and systemic examination. Statistical analysis was done with the help percentage, mean and standard deviation.<strong></strong></p><p class="abstract"><strong>Results:</strong> Out of 400 patients, 216 (54%) were primigravidae and 184 (46%) were multigravidae. Majority of the patients (55%) were in the age group of 21-25 years. Physiological changes were present in all patients and specific dermatoses in 8.75% of patients. The commonest mucosal change was Jacquemier-Chadwick Sign (96.5%) followed by gingivitis (2.5%). Most common pigmentary change recorded was linea nigra. Most common specific dermatoses reported was prurigo of pregnancy (8%) followed by pruritic urticarial papules and plaques of pregnancy (0.5%). Prurigo of pregnancy was more frequently recorded in multigravida patients and more frequently in third trimester of pregnancy. The commonest dermatosis not specific to pregnancy observed was dermatophyte infection.</p><p class="abstract"><strong>Conclusions:</strong> Awareness about various cutaneous changes in pregnancy is important for correct diagnosis that will direct the most appropriate laboratory evaluation and careful management in an effort to minimize maternal and fetal morbidity.</p>

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 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].…”

“…Dermatosis of pregnancy or pregnancy-specific dermatosis is a major cause of morbidity during pregnancy and its prevalence has ranged from 2% [ 12 , 17 ] to 40.85% [ 8 ], whereas one study [ 9 ] reported that these pregnancy-specific dermatoses can affect up to 85.5% of pregnant women. Dermatosis specific to pregnancy included mainly, but not limited to, prurigo of pregnancy (8%-47.12%) [ 8 , 14 ], pruritic urticarial plaques, and papules of pregnancy (0.5%-43.93%) [ 8 , 14 ], and atopic eruption of pregnancy (4%-72.72%) [ 9 , 13 ].…”

“…It mostly appears in the second trimester of pregnancy [ 21 ] and can affect up to 50% to 70% of women [ 22 ]; in this systematic review, however, only one study [ 18 ] reported that half of the pregnant women experienced melasma. Though some studies have shown that these pigmentary lesions could affect a wide range of pregnant women [ 13 , 17 ], The prevalence of such pigmentary skin lesions during pregnancy can truly vary depending on various factors, but some studies have reported that almost every single gravid woman may complain from pigmentary skin changes during pregnancy [ 12 , 14 , 15 ].…”