Rashes in pregnancy

Question 1

polymorphic eruption of pregnancy is also known as

Answer 1

puritic and uritcarial papules and plaques of pregnancy

Question 2

when does polymorphic eruption of pregnancy present?

Answer 2

in the 3rd trimester

it is caused by the skin stretching

Question 3

where is polymorphic eruption of pregnancy found?

Answer 3

he abdomen, particularly associated with the striae

Question 4

true or false: polymorphic eruption of pregnancy tends to get better towards the end of pregnancy

Answer 4

rue; the skin is not being so stretched any more

Question 5

3 types of lesions that may be seen in polymorphic eruption of pregnancy

Answer 5

urticarial papules

plaques

wheals

Question 6

management of polymorphic eruption of pregnancy

Answer 6

eczema management

Question 7

2 presentations of atopic eruption of pregnancy

Answer 7

E-type: presents exactly like eczema

P-type (prurigo type): presents with intensely itchy papules on the abdomen, back and limbs
when does AEoP present?
in the 1st or 2nd trimesters

Question 8

when does Atopic Eruption of Pregnancy present?

Answer 8

in the 1st or 2nd trimesters

Question 9

how is AEoP managed?

Answer 9

eczema management

Question 10

what is melasma?

Answer 10

hyperpigmentation of the face (associated with pregnancy)

Question 11

what does melasma look like? (what are the patches like?)

Answer 11

the patches are symmetrical and flat hyperpigmented areas

Question 12

5 causes of melasma

Answer 12

pregnancy

COCP

HRT

thyroid disease

FHx

Question 13

exacerbates melasma

Answer 13

sun exposure

Question 14

how is melasma managed

Answer 14

it is purely cosmetic i.e. if the patient isn’t bothered then you shouldn’t be either

avoid sun exposure and use makeup (other treatments are available outside of the NHS)

Question 15

what is a pyogenic granuloma?

Answer 15

a rapid growly, benign capillary haemangioma

Question 16

appearance of a pyogenic granuloma

Answer 16

a discrete lump 1-2cm which is red or darkly coloured

Question 17

4 causes of pyogenic granuloma

Answer 17

pregnancy

Exogenous hormones

minor trauma

infections

Question 18

where do pyogenic granulomata generally present?

Answer 18

on the fingers or on the upper chest, neck, back or head

Question 19

suggest why a pyogenic granuloma could be troubling/cause symptoms

Answer 19

they can bleed profusely when injured

Question 20

management of pyogenic granuloma

Answer 20

surgery and histology

NB in pregnancy you can just leave them because they will go away with delivery

Question 21

what is the pathophysiology of gestational pemphigoid?

Answer 21

antibodies are produced against the placenta and this leads to damage to the skin at the level of the basement membrane

Question 22

when does gestational pemphigoid occur?

how does it initially present?

Answer 22

2nd or 3rd trimester

presents with itchy rash around the umbilicus, and this later develops to blisters

Question 23

true or false: the blisters in gestational pemphigoid heal without scarring

Answer 23

true

Question 24

management of gestational pemphigoid

Answer 24

emollients, steroids (generally oral)

immunosuppresion

Question 25

3 risks from gestational pemphigoid to the foetus

Answer 25

premature delivery

IUGR (foetus is unwell)

blistering rash on the baby (antibodies have crossed the placenta)