DERMATOLOGIC DISORDERS IN OBSTETRICS

Question 1

elevated by 8 weeks AOG

Answer 1

MSH

Question 2

Develops in 90% of pregnant women

Answer 2

Pigmentation

Question 3

Prevention of pigmentation

Answer 3

avoid excessive sun exposure

Question 4

• pemphigoid gestations

- pruritic urticarial papules and plaques of pregnancy

Answer 4

INTRAHEPATIC CHOLESTASIS

Question 5

• Pruritus gravidarum
• 0.5% incidence
• associated with abnormally elevated serum levels of Bile acids
• Rash precedes pruritus

Answer 5

Intrahepatic Cholestasis

Question 6

• Autoimmune bullous disease
• Papules and plaques x 2 weeks
• Lesions: periumbilical
• subepidermal edema with perivascular infiltrates of lymphocytes, histocytes, and eosinophils

Answer 6

Pemphigoid Gestationis

Question 7

-treatment of Pemphigoid Gestationis

Answer 7

• Skin biopsy, serum antibody assay
• topical High potency CS, oral AH
• Oral Prednisone 0.5 – 1 mg/kg – tapered
• Plasma pharesis, IVIG

Question 8

• Benign effect on pregnancy
• Intensely pruritic 1-2 mm erythematous papule that coalsece to form urticarial plaques
• 97% abdomen and thighs
• White women, nulliparous
• carrying a male offspring
• most cases resolve after delivery, or some 3-4 weeks post partum

Answer 8

Pruritic urticarial papules and plaques (PUPPP)

Question 9

TX of Pruritic urticarial papules and plaques

Answer 9

oral AH, emollients, corticosteroids

Question 10

-Encompasses eczema of pregnancy, prurigo of pregnancy and pruritic folliculitis of pregnancy
-2/3 Widespread eczematous changes,
1/3 papular lesions
-Eczema in Pregnancy
-Prurigo Gestationis
-Pruritic folliculitis of pregnancy
-ONSET: second trimester of pregnancy

Answer 10

ATOPIC ERUPTION of Pregnancy (AEP)

Question 11

TX of Atopic Eruption Pregnancy

Answer 11

-Low to moderate potency topical corticosteroids, antihistamine

Question 12

• no primary lesions , secondary excoriations from scratching
• increased perinatal morbidity

Answer 12

Cholestasis of pregnancy

Question 13

-treatment of Cholestasis of pregnancy

Answer 13

-antipruritics, cholestyramine, ursodeoxycholic acid

Question 14

• common

- dry, red scaly patches on extremity flexures, neck, face

Answer 14

Eczema of Pregnancy

Question 15

-common

1-5 mm pruritic red papules on extensor surfaces, trunk

Answer 15

Prurigo of Pregnancy

Question 16

• rare

- small red papules, sterile pustules on trunk

Answer 16

Pruritic folliculitis of Pregnancy

Question 17

• dermatologic conditions not specific to pregnancy

- Topical retinoids : not safe in pregnancy esp during first trimester

Answer 17

ACNE VULGARIS

Question 18

TX of Acne Vulgaris

Answer 18

topical erythromycin, clindamycin

Question 19

• dermatologic conditions not specific to pregnancy

- no risk of adverse pregnancy outcome

Answer 19

PSORIASIS

Question 20

-Tx of Psoriasis

Answer 20

emollients

Question 21

systemic sx

Answer 21

General pustular psoriasis of pregnancy

Question 22

Treatment of General pustular psoriasis of pregnancy

Answer 22

• prednisone, cyclosporine, infliximab, topical steroids
• Secondary infection: antibiotic IV
• resolves quickly during puerperium

Question 23

• dermatologic conditions not specific to pregnancy
• Inflammation of subcutaneous fat
• 1-6cm, red warm, tender nodules on the extensor surface of legs
• Symptoms resolve in 1-6 weeks without scarring

Answer 23

Erythema Nodosum

Question 24

• dermatologic conditions not specific to pregnancy
• Frequently seen in pregnancy
• Lobular capillary hemangioma forming on the mouth and hand
• for active bleeding: monsel paste
• Resolve within months postpartum

Answer 24

Pyogenic Granuloma

Question 25

• dermatologic conditions not specific to pregnancy
• Neurofibroma, café au lait spots, axillary and inguinal freckling benign nodules of the iris, optic nerve glioma,
• May increase in size and no. during pregnancy

Answer 25

Neurofibromatosis

Question 26

higher incidence of pre-eclampsia and Preterm delivery

Answer 26

Type 1 Neurofibromatosis