A study of pregnancy specific dermatoses and their effect on the outcome of pregnancy

Authors

  • Anju S. Nair Kerala Government Health Services, India
  • George Kurien Department of Dermatology, Government Medical College, Kottayam, Kerala, India
  • V. G. Binesh Department of Dermatology, Government Medical College, Kottayam, Kerala, India

DOI:

https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20172104

Keywords:

Pregnancy dermatoses, PUPPP

Abstract

Background: Pregnancy being a complex state, the interactions of multiple factors result in a number of cutaneous findings that can be separated into physiologic changes, pre-existing dermatoses that can be aggravated or improved during pregnancy and dermatoses that are specific to pregnancy. Dermatoses specific to pregnancy are important to recognise because they may be pruritic or painful to the mother and may pose significant risk to mother, her fetus or both. Early identification of the condition may go a long way in preventing morbidity and mortality.

Methods: Antenatal women attending dermatology outpatient for dermatologic problems or referred from Obstetrics and Gynaecology, department for skin conditions in a tertiary care hospital in Kottayam, Kerala state were taken up for the study. Pregnancy related dermatoses or physiologic changes due to pregnancy if present were noted. The patients were followed up till delivery and the pregnancy outcome recorded. The results were analyzed using SPSS.

Results: 94.3% of the patients had physiological changes, hyperpigmentation being the commonest. Specific pregnancy dermatoses were present in 38.3%. 94% of pregnancy dermatoses occurred during third trimester. The most common specific dermatoses observed was pruritic urticarial papules and plaques of pregnancy (PUPPP)-63.6%. It is more common in primi gravida (30/42), in   twin pregnancies, in mothers of babies with more birth weight, male babies and those with gestational diabetes mellitus. None of the specific dermatoses produced adverse fetal outcome.

Conclusions: Pregnancy dermatoses usually manifest in the third trimester. PUPPP is the commonest pregnancy dermatosis. PUPPP is more common among mothers with increased body weight, gestational diabetes, in twin pregnancy and in mothers with male babies. Most of the common pregnancy dermatoses have no adverse effect on the fetus.

Author Biographies

Anju S. Nair, Kerala Government Health Services, India

Junior consultant

George Kurien, Department of Dermatology, Government Medical College, Kottayam, Kerala, India

Addl.Professor

V. G. Binesh, Department of Dermatology, Government Medical College, Kottayam, Kerala, India

Associate professor

References

Barankin B, Silver SG, Carruthers A. The skin in pregnancy. J Cutan Med Surg. 2002;6:236-40.

Engineer L, Bhol K, Ahmed AR. Pemphigoid gestationis: A review. Am J Obstet Gynecol. 2000;183:483-91.

Ambros-Rudolph CM, Mullegger RR, Vaughan Jones SA, Kerl H, Black MM. The specific dermatoses of pregnancy revisited and reclassified: Results of a retrospective two center study on 505 pregnant patients. J Am Acad Dermatol. 2006;54(3):395-404.

Rathore SP, Gupta S, Gupta V. Pattern and prevalence of physiological cutaneous changes in pregnancy; A study of 2000 antenatal women. Indian J Dermatol Venereol Leprol. 2011;77:402.

Kumari R, Jaisankar TJ, Thappa DM. A clinical study of skin changes in pregnancy. Indian J Dermatol Venereol Leprol. 2007;73:141.

Muzaffar F, Hussain I,Haroon TS. Physiologic skin changes during pregnancy: A study of 140 cases. Int J Dermatol. 1998;37:429-31.

Shivakumar V, Madhavamurthy P. Skin in pregnancy. Indian J Dermatol Venereol Leprol. 1999;65:23-5.

Raj S, Khopkar U, Kapasi A, Wadhwa SL. Skin in pregnancy. Indian J Dermatol Venereol Leprol. 1992;58:84-8.

Vaughan Jones SA, Hern S, Nelson-Piercy C, Seed PT, Black MM. A prospective study of 200 women with dermatoses of pregnancy correlating clinical findings with hormonal and immunopathological profiles. Br J Dermatol. 1999;141:71-81.

Beckett MA, Goldberg NS. Pruritic urticarial papules and plaques of pregnancy and skin distension. Arch Dermatol. 1991;127:125-6.

Bunker CB, Erskine K, Rustin MH, Gilkes JJ. Severe polymorphic eruption of pregnancy occurring in twin pregnancies. Clin Exp Dermatol. 1990;15:228-31.

Cohen Lm, Capeless EL, Krusinski PA, Maloney ME. Pruritic urticarial papules and plaques of pregnancy and its relationship to maternal-fetal weight gain and twin pregnancy. Arch Dermatol. 1989;125:1534-6.

Regnier S, Fermand V, Levy P, Uzan S, Aractingi SA. A case control study of polymorphic eruption of pregnancy. J Am Acad Dermatol. 2008;58:63-7.

Nelson JL, Maloney S, Gooley T, Evans PC, Smith A, Bean MA. Microchimerism and HLA compatible relationships of pregnancy in scleroderma. Lancet. 1998;351:559-62.

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Published

2017-05-22

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Original Research Articles