Pregnancy skin changesO99.7
Synonym(s)
Dermatoses of pregnancy; Pregnancy dermatoses; Pregnancy-specific dermatoses; Skin diseases during pregnancy
DefinitionThis section has been translated automatically.
Group of heterogeneous, physiological and pathological (so-called specific pregnancy dermatoses) skin changes that occur during pregnancy and are largely reversible after pregnancy. Pre-existing skin diseases can also be positively or negatively influenced during pregnancy.
ClassificationThis section has been translated automatically.
A distinction is made between:
Pregnancy-related skin changes:
- Hyperpigmentation (melanotic dyschromias):
- Hyperpigmentation (up to 90% of pregnant women) especially of the nipples, genitals, linea fuscea (linea nigra). Less frequent are hyperpigmentation along the front of the upper arm, the back of the thigh, the so-called Voight lines.
- Melasma gravidarum
- Hyperpigmentation of melanocytic nevi.
- Changes in connective tissue:
- Striae cutis distensae (up to 90% of pregnant women).
- Vascular changes:
- Palmar erythema (erythema palmare et plantare symptomaticum).
- gingival hyperemia and hyperplasia
- Pregnancy gingivitis
- Epulis gravidarum (pregnancy tumor)
- Nevi aranei and other telangiectasias
- Granuloma pyogenicum
- Lymphedema
- Varices
- Hemorrhoids
- Changes of hair(Remark! During pregnancy, hair is usually in remarkably good condition. Problems usually appear only after pregnancy)
- Nail changes: rarely, there is increased brittleness or slight surface cracking; otherwise, the nails are usually unproblematic.
- Changes in glandular functions:
- Hyperfunction of the eccrine glands is possible (hyperhidrosis).
- Apocrine glands are dysfunctional
Dermatoses influenced by pregnancy:
Pregnancy-specific dermatoses:
- pregnancy cholestasis (intrahepatic cholestasis of pregnancy = ICP = pruritus gravidarum)
- Pemphigoid gestationis (herpes gestationis)
- Polymorphous pregnancy dermatosis (PUPP)
- Papular dermatitis in pregnancy (entity disputed)
- Pregnancy dermatosis, atopic
- Autoimmune progesterone dermatitis in pregnancy.
- Folliculitis, pruritic of pregnancy (entity disputed).
EtiopathogenesisThis section has been translated automatically.
During pregnancy, complex endocrinological, immunological, metabolic and vascular changes lead on the one hand to the occurrence of pregnancy-specific physiological (skin) changes, which are largely reversible after pregnancy. On the other hand, pregnancy-specific pathological (skin) changes can manifest themselves. Furthermore, diseases can be defined which can be changed positively or negatively by a pregnancy (see classification).
TherapyThis section has been translated automatically.
See below the respective clinical picture. Basically, in the case of considerable itching:
- Cooling gels, moist compresses, cool douches.
- Tannin 3-5% in lotio alba (apply very thinly)
- Urea (3-5%), menthol (1-2%) or polidocanol (2-5%) in cream or lotion base (e.g. Unguentum emulsificans aquosum or
- "Underdosed" non-halogenated topical glucocorticoids (e.g., 0.5% hydrocortisone acetate).
- Systemic glucocorticoids if significant pruritus. Prednisolone usually short-term therapy only (<4 weeks). In 1st trimester, do not exceed dose of 10-15mg/day for prolonged use.
- Systemic antihistamines(dimetindene, clemastine, loratadine).
Note(s)This section has been translated automatically.
The influence of pregnancy on the prognosis of women with melanoma was clearly negated in 10 case-control studies. In several large studies, no difference could be demonstrated with regard to overall survival or disease-free survival with adequate therapy. There is no need to refuse pregnancy in women with a previous melanoma disease. Women in a later stage of melanoma disease should be informed about the increased risk that their child may grow up motherless.
LiteratureThis section has been translated automatically.
- Ambros-Rudolph CM (2006) Dermatoses of pregnancy. J Dtsch Dermatol Ges 4: 748-759
- Ambros-Rudolph CM (2010) Specific pregnancy dermatoses. Dermatologist 61: 1014-1020
- Böer B et al.(2014) Skin diseases and allergies during pregnancy. Act Dermatol 40: 457-467