Specific dermatoses of pregnancy: advances and controversies

Abstract

Specific dermatoses of pregnancy include herpes (pemphigoid) gestationis, polymorphic eruption of pregnancy (also known as pruritic urticarial papules and plaques of pregnancy), prurigo of pregnancy and pruritic folliculitis of pregnancy. This article focuses on what is currently known about the epidemiology, clinical characteristics, etiopathogenesis and management of these disorders. Moreover, it discusses the intrahepatic cholestasis of pregnancy and 'atopic eruption of pregnancy', which were recently reclassified as specific dermatoses of pregnancy, as well as debates related to the prevalence and diagnostic criteria of the latter. Finally, it addresses the suggested overlap between 'atopic eruption of pregnancy' and specific dermatoses of pregnancy, such as prurigo and pruritic folliculitis. Keywords: atopic dermatitis • cholestasis • herpes gestationis • polymorphic eruption of pregnancy • prurigo of pregnancy • pruritic folliculitis of pregnancy

Advanced Pemphigoid Gestationis Initially Misdiagnosed as Pruritic Urticarial Papules and Plaques of Pregnancy

“…Pemphigoid gestationis (PG), previously known as herpes gestationis, is a rare autoimmune skin condition that affects between 1 in 10,000 and 1 in 50,000 pregnancies [1]. It is related to the pemphigoid skin disorders.…”

“…The differential diagnoses include other dermatoses of pregnancy, drug reaction, erythema multiforme (EM) and contact dermatitis [2]. Diagnosis is confirmed with lesion biopsy showing linear C3 deposition along the basement membrane zone [1][2][3]. Goals of treatment are to relieve symptoms, decrease further bullae formation, and promote healing of the lesions.…”

Pruritic Folliculitis of Pregnancy

“…It typically develops in the second quarter of pregnancy [1][2][3][4][5][6][7] , and the incidence rate is approximately 1 in 3,000 pregnancies. 7 Its etiology is uncertain, probably due to its rare ocurrence.…”

“…7 Its etiology is uncertain, probably due to its rare ocurrence. 1,6,7 A few studies on the subject have been conducted, and a few cases have been reported in the literature. It is believed that many cases are under-reported, as it is often confused with bacterial folliculitis .1,7…”

“…PUPPP, prurigo of pregnancy, and gestational pemphigoid). [1][2][3][4][5][6][7] The absence of bullous lesions accompanied by non-specific histopathology, as well as negative immunofluorescence, might help differentiate pruritic folliculitis of pregnancy from gestational pemphigoid. PUPPP may be distinguished from PFP by the absence of pregnancy stretch marks and skin rashes, typical of PUPPP.…”