Pregnancy related rashes Flashcards
What are some pregnancy related rashes?
Polymorphic eruption of pregnancy
Atopic eruption of pregnancy
Melasma
Pyogenic granuloma
Pemphigoid gestationis
When does polymorphic eruption of pregnancy usually occur?
3rd trimester
What occurs in polymorphic eruption of pregnancy
- Urticarial papules(raised itchy lumps)
- Wheals(raised itchy areas of skin)
- Plaques(larger inflamed areas of skin)
- Usually beginning on the abdomen
- Associated with stretch marks
Management of polymorphic eruption of pregnancy
- Topical emollients
- Topical steroids
- Oral antihistamines
- Oral steroids may be used in severe cases
What is atopic eruption of pregnancy
Atopic eruption of pregnancy essentially refers to eczema that flares up during pregnancy. This includes both women that have never suffered with eczema and those with pre-existing eczema.
When does atopic eruption of pregnancy occur
1st and 2nd trimester
What are the 2 types of atopic eruption of pregnancy
- Eczema-type
- Prurigo-type
What is eczema type atopic eruption of pregnancy
eczematous, inflamed, red and itchy skin, typically affecting the insides of the elbows, back of knees, neck, face and chest.
What is prurigo-type atopic eruption of pregnancy
intensely itchy papules (spots) typically affecting the abdomen, back and limbs.
Management of atopic eruption of pregnancy
- Topical emollients
- Topical steroids
- Phototherapy with ultraviolet light (UVB) may be used in severe cases
- Oral steroids may be used in severe cases
What is melasma?
increased pigmentationto patches of the skin on the face. This is usually symmetrical and flat, affecting sun-exposed areas.
What causes melasma?
increased female sex hormones associated with pregnancy. It can also occur with thecombined contraceptive pillandhormone replacement therapy. It is also associated with sun exposure, thyroid disease and family history.
Management of melasma
- Avoiding sun exposure and using suncream
- Makeup (camouflage)
- Skin lightening cream (e.g. hydroquinone or retinoid creams), although not in pregnancy and only under specialist care
- Procedures such as chemical peels or laser treatment (not usually on the NHS)
What is pyogenic granuloma
a benign, rapidly growing tumour ofcapillaries. It present as a discrete lump with a red or dark appearance.
What causes pyogenic granuloma
Pregnancy, and can also be associated with hormonal contraceptives. They can also be triggered by minor trauma or infection.
How does pyogenic granuloma present
a rapidly growing lump that develops over days up to 1-2 cm in size, (but can be larger). They often occur onfingers, or on the upper chest, back, neck or head. They may cause profuse bleeding and ulceration if injured.
Management of pyogenic granuloma
Surgical removalwithhistologyto confirm the diagnosis.
What is pemphigoid gestationis
a rareautoimmuneskin condition that occurs in pregnancy.Autoantibodiesare created that damage the connection between theepidermisand thedermis. The pregnant woman’s immune system may produce theseantibodiesin response toplacental tissue. This causes theepidermisanddermisto separate, creating a space that can fill with fluid, resulting in large fluid-filled blisters (bullae).
When does pemphigoid gestationis occur
2nd or 3rd trimester
How does pemphigoid gestationis present
itchy red papular or blistering rash around the umbilicus, that then spreads to other parts of the body. Over several weeks, large fluid-filled blisters form.
Management of pemphigoid gestationis
- Topical emollients
- Topical steroids
- Oral steroids may be required in severe cases
- Immunosuppressants may be required where steroids are inadequate
- Antibiotics may be necessary if infection occurs
Risks of pemphigoid gestationis to the baby
- Foetal growth restriction
- Preterm delivery
- Blistering rash after delivery (as the maternal antibodies pass to the baby)
