105 - Skin Changes and Diseases in Pregnancy Flashcards
Most common physiologic change in pregnancy
Pigmentary disturbances
Y/N: Significant change in nevi size is a feature of most pregnancies
No - not a feature
Y/N: Any pigmented lesion in a pregnant women that undergoes change in morphology or symptoms should be considered for histopathologic review
Yes
Most common structural change during pregnancy
Striae distensae
Strongest predictors of an individual’s risk of developing striae
Family history
Personal history
Race
Most common vascular lesions to develop in pregnancy
Spider angioma
Dermatoses associated with fetal risk in pregnancy
Pemphigoid gestationis
Intrahepatic cholestasis of pregnancy
Pustular psoriasis of pregnancy
Dermatosis in pregnancy that includes periumbilical skin
Pemphigoid gestationis
Y/N: PG is associated with premature delivery and a risk of low birth weight; the risk of these fetal complications correlate with maternal disease severity
Yes
Y/N: First-generation antihistamines are favored over second-generation antihistamines in PG
Yes
Only pregnancy dermatosis that presents without primary skin lesions
ICP
Symptoms of _____ are generally more severe at night
ICP
Single most sensitive indicator of ICP
Elevation in serum bile acids
Total serum bile acid levels greater than _____ are consistent with ICP
11 microM/L
Y/N: Degree of pruritus and disease severity generally correlate with bile acid concentrations
Yes
Particularly sensitive, as an elevation in this enzyme is not a feature of healthy pregnancies but is commonly seen in ICP
Alanine transaminase
Y/N: Cutaneous biopsy aids in the diagnosis of ICP
No
Maternal outcomes are generally favorable in ICP, although women with severe cases are predisposed to
Postpartum hemorrhage secondary to vitamin K depletion
Women affected with ICP have a tendency toward the later development of
Cholelithiasis or gallbladder disease
Current treatment of choice in ICP
Ursodeoxycholic acid (UDCA), a naturally occurring hydrophilic bile acid
Pustular psoriasis of pregnancy typically originates in ______, spreads _____ and sometimes generalizes
Flexural areas
Centrifugally
Life-threatening maternal complications are infrequent in impetigo herpetiformis but may result from
Profound hypocalcemia
Bacterial sepsis
Most feared complications of impetigo herpetiformis
Placental insufficiency and consequent stillbirth or neonatal death
Distinguish impetigo herpetiformis from pustular psoriasis
Absence of a positive family history
Abrupt resolution of symptoms at delivery
Tendency to recur only during subsequent pregnancies
Recurrences of impetigo herpetiformis in subsequent pregnancies are common and characteristically (less/more) severe with onset (earlier/later) in gestation
More
Earlier
First-line therapy in impetigo herpetiformis
Cyclosporine
Infliximab
Dermatoses not associated with fetal risk in pregnancy
Polymorphic eruption of pregnancy
Atopic eruption of pregnancy
Occurs almost exclusively in primigravidas
Polymorphic eruption of pregnancy
Lesions of PEP are most commonly
Urticarial
Eruption begins on the abdomen classically within the striae gravidarum, and demonstrates periumbilical sparing
Polymorphic eruption of pregnancy
Y/N: In PEP, spontaneous remission within days of delivery is the rule. Recurrences in subsequent pregnancies or with exposure to oral contraceptives are usual
No - unusual
Most common pruritic condition of pregnancy
Atopic eruption of pregnancy
Types of atopic eruption of pregnancy
E-type (eczematous)
P-type (papular)
Distinguishing features of AEP
Onset early in pregnancy (before the third trimester)
Personal and/or family history of atopy
