pregnancy skin disease

Question 1

common physiological chanegs in skin disease in pregnancy 6

Answer 1

hyperpigmentation

straie gravidarum

hair and nail chanegs

vascular- angiomas, spider naevi

greasier skin

pruritus

Question 2

common skin diseases in pregnnacy 6

Answer 2

atopic eruption of pregnancy

acne vulgaris or rosacea

psoriasis (emmolients/steroids/dithranol/UVB)

infections (candida, viral warts, varicella)

infesttations (scabies)

autoimmune (SLE, pemphigus)

Question 3

specific derm pregnancy conditions 4

Answer 3

atopic eruption of pregnnacy (AEP)

polymorphic eruption of pregnancy (PEP)

pehmphigoid gestattionis (PG)

obsteric cholestasis

Question 4

commonest pregnnacy rash

Answer 4

atopic eruption of pregnancy

Question 5

presentation of atopic eruption of pregnancy 3

Answer 5

before 3rd trimester

trunks and limbs involved

previous Hx of eczema in 20%

Question 6

describe the two types of atopic eruptions in pregnancy

Answer 6

eczematous - E type AEP
-rough red patches develop
-typically occurs on face, neck, creases or elbow and backs of knees [14]

prurigo P-type AEP
-bumps develop
-can affect widespread areas like abdomen, arms and legs [15]

Question 7

treatment for atopic eruptions in pregnancy 6

Answer 7

emollients

aqueos cream and menthold

topical steroids

antihistamines

narrow band UVB (2nd line)

oral steroids if severe (30mg pred)

Question 8

presentation of polymorphic eruptions of pregnnacy 4

Answer 8

3rd trimester or postpartum - also usually prim

pruritic eruption, lower abdomen and striae
-UMBILICAL SPARING
-distant spread [16]

Question 9

treatment for polymorphic eruptions of pregnancy 3

Answer 9

provide selfcare to reliver itching

prescribe symptomatic treatment when necessary
-emollients
-moderate-potent topical steroids
-sedating antihistamine if itch affecting sleep

Question 10

presentation of pemphigoid gestationis 4

Answer 10

2nd or 3rd trimester

urticarial lesions, wheals and bullae,
-umbilical area [17]

autoimmune- binding of IgG to basement membrane

Question 11

risks with pemiphgoid gestationis 4

Answer 11

usualy recurs

-whilst rare include:
-premature delivery
-fetal growth restriction
-transiesnt blisterining of infant - resolves with clearance of maternal antibodies

secondary infection can leave scarring

Question 12

treatment for pemphigoid gestatitions 2

Answer 12

refer to derm and obstertics

topical coritcosteroids and antihistmiens for mild cases

moderate/severe cases- specialists and systemic steroids

additional antenatal surveillance - due to increased risk of preterm birth and reduced fetal growth