Skin

Question 1

Skin changes in pregnancy

Answer 1

Striae gravidarum
Lines negra 
Melasma
Palmar erythema 
Hair-shinier and thicker
Hirsuitism

Question 2

Striae gravidarum

Answer 2

Strophic linear scars; Estrogen alters distribution and function of elastin fibres and elastin microfibrils
Physical and genetic factors also involved

Question 3

Melasma: symmetric patches of light brown pigmentation across the face

Answer 3

Estrogen stimulates melanocytes which I increases melatonin

Genetic, environmental, and cosmetics

Question 4

Linea nigra: increased pigmentation extending from pubic to umbilicus

Answer 4

Estrogen stimulates production of melanocyte stimulating hormone causing increased activity of melanocytes

Question 5

Palmer erythema: redness across hypothenar thenar and/or palm

Answer 5

Progesterone causes vasodilation and decreased systemic vascular resistance contributes to peripheral vascular congestion

Question 6

Hair

Hirsuitism

Answer 6

Increased ovarian hormones and androgens stimulate the pilosebaceous unit, promote the growth phase of the hair follicles leading to reduced shedding

Question 7

Eczema

Answer 7

Improves in pregnancy

Question 8

Acne

Answer 8

Worsens due to increasing ovarian hormones and androgens

Question 9

PUPPS/PEP

Answer 9

1:200
No fetal/neonatal risks
Maternal discomfort/poor sleep
Rarely gets infected
Spares peri-umbilical area
Negative immunoflorescense

Question 10

PG (pemphigus gestationis)

Answer 10

1:10000-50000
Increased fgr &sb 
High likelihood pp flare
Risk of neonatal eruption (10%)
High likelihood recurrence in future pregnancy 
Often starts and involves umbilicus
Large tense bullae 
Skin bx with positivity immunoflourescence