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Pemphigoid gestationis (PG) is a rare autoimmune bullous skin disorder which usually presents with intense pruritus and urticarial lesions that may evolve into vesicles and tense blisters. In majority of patients, it starts in the second or third trimester of pregnancy and resolves spontaneously after delivery. Lesions appear in the periumbilical area in 90% of patients and rapidly spread centrifugally to other parts of the body. The diagnosis needs to be confirmed by direct immunofluorescence test (DIF) with indirect immunofluorescence test (IIF), ELISA and immunoblot techniques playing role in diagnosis and/or monitoring antibodies level. Mild symptoms of PG can be treated with topical therapy only, but in severe course of the disease the treatment may be escalated to oral corticosteroids. We present an unusual case of PG started 2 weeks after delivery with an updated overview on the epidemiology, pathology, clinical picture, treatment, and complications of the disease. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Pregnancy is associated with many systemic changes mostly linked with hormones. The skin shows many of these changes as dermatoses - directly related to the pregnancy or an exacerbation/amelioration of a prenatal condition. A few of the pregnancy dermatoses can be fatal if unrecognised early. The aim of this study was to document the spectrum of pregnancy dermatoses and effect on quality of life of pregnant women presenting at the antenatal clinics of two tertiary hospitals in South west Nigeria. METHODS: a prospective observational cohort study carried out concurrently at the antenatal clinics of two tertiary hospitals: Lagos University Teaching Hospital (LUTH) and Olabisi Onabanjo University Teaching Hospital (OOUTH) over seven months. Consecutive patients filled questionnaires and had full dermatology examination by specialists with results documented and analysed with SPSS 21st edition. RESULTS: of 296 patients studied, 175; 59.1% first presented for antenatal clinic in the 3rd trimester. Most common symptom was itching (125; 42.2%) and 85.5% had signs of dermatoses. Atopic eruption of pregnancy (AEP) and pruritic urticarial papules and plaques of pregnancy were seen in (11; 3.7%) of patients. A background history of atopic dermatitis was significantly associated with AEP. The most common non-specific pregnancy dermatoses were acne vulgaris (129; 43.6%), superficial fungal infections (119; 40.2%) and melasma (55; 18.6%). CONCLUSION: skin conditions are common in pregnancy; fatal pregnancy dermatoses were not seen in this study.

Hyperkeratosis of the nipple is an uncommon, benign, asymptomatic, acquired condition of unknown pathogenesis. Most cases are bilateral, although unilateral cases had been reported. Breastfeeding is usually not affected. Physiologic changes of the nipple and areola during pregnancy include enlargement, hyperpigmentation, secondary areolae, erectile nipples, prominence of veins, striae, and enlargement of the Montgomery glands or tubercles (hypertrophied sebaceous glands). Women with unilateral primary hyperkeratosis of the nipple and/or areola (HNA) may have bilateral disease during pregnancy (secondary HNA). Pregnancy may also produce thicker, darker lesions. Here, we report a case of pregnancy-associated hyperkeratosis of the nipple in a primigravida. We counseled her about the benign nature of the condition and treated her with topical steroids and moisturizers.

Hyperkeratosis of nipple is uncommon, benign, asymptomatic, acquired condition of unknown pathogenesis. Most cases are bilateral, although unilateral cases had been reported. Breastfeeding is usually not affected. Physiologic changes of the nipple and areola during pregnancy include enlargement, hyperpigmentation, secondary areolae, erectile nipples, prominence of veins, striae, and enlargement of the Montgomery glands or tubercles (hypertrophied sebaceous glands). Women with unilateral primary hyperkeratosis of the nipple and/or areola may have bilateral disease during pregnancy (secondary hyperkeratosis of the nipple and/or areola). Pregnancy may also produce thicker, darker lesions. Here, we report a case of pregnancy-associated hyperkeratosis of nipple in a primigravida. We counseled her about benign nature of the condition and treated her with topical steroids and moisturizers.

Background/objective: Pregnant women experience a myriad of physiological and metabolic changes that affect different organ systems in the body. Cutaneous and appendageal alterations that manifest during pregnancy are largely modulated by hormonal, immunologic, and metabolic factors. Detailed reports encompassing physiological changes and specific dermatoses of pregnancy and effects of various dermatoses on pregnant women are scanty in literature. This study was conducted to examine in detail both physiological changes and specific dermatoses. The cutaneous changes are divided into physiological changes, skin diseases aggravated by pregnancy, and specific dermatoses of pregnancy. The objectives were to study the various cutaneous changes of pregnancy and to know the proportion of these cutaneous manifestations in pregnant women. Methods: This study included 600 pregnant women attending the Obstetrics and Gynecology Department of a tertiary teaching hospital in Northern Kerala, India. Detailed history elicitation and complete physical and dermatological examination were performed. Skin biopsy was performed in relevant cases. Results: Cutaneous changes were seen in a majority of patients, of which physiological changes were the most common (99%). The most common cutaneous manifestation was hyperpigmentation (526; 87.6%), followed by striae gravidarum (72.8%). Other changes were vascular, including pedal edema (10%), pregnancy gingivitis (1.8%), and varicose veins (1%). Infections were the common dermatological problem in this study group. The most common infections were vulvovaginal candidiasis (21%), Tinea versicolor (6%), scabies (2.8%), dermatophytosis (1.5%), and sexually transmitted infection (0.5%). Specific dermatoses were seen in 12 cases (2%), with the most common being pruritic urticarial papules and plaques of pregnancy (1.3%). Conclusion: Pregnant women are prone to suffer from a wide range of dermatological problems apart from specific dermatoses of pregnancy. The study emphasizes the need for a detailed and meticulous examination of these patients to detect these various disorders.

A 32-year-old Thai woman in her first pregnancy presented with multiple hyperpigmented, hyperkeratotic, pruritic, discrete papules coalescing to form plaques with a rippled pattern on the extensor surfaces of upper and lower limbs, back, chest, and abdomen. Her mother had a similar history. Histopathology of the lesion revealed a diagnosis of lichen amyloidosis, confirmed by the Congo red stain. The lesions had started one year prior and had remained stable before pregnancy; however, they became widespread after pregnancy. Thus, prompting the question as to whether this was a coincidence or if the pregnancy had exacerbated the condition. In this case report, we will discuss our approach to this patient and our opinions concerning the relationship between pregnancy and lichen amyloidosis. [ABSTRACT FROM AUTHOR]

Background/objective Pregnant women experience a myriad of physiological and metabolic changes that affect different organ systems in the body. Cutaneous and appendageal alterations that manifest during pregnancy are largely modulated by hormonal, immunologic, and metabolic factors. Detailed reports encompassing physiological changes and specific dermatoses of pregnancy and effects of various dermatoses on pregnant women are scanty in literature. This study was conducted to examine in detail both physiological changes and specific dermatoses. The cutaneous changes are divided into physiological changes, skin diseases aggravated by pregnancy, and specific dermatoses of pregnancy. The objectives were to study the various cutaneous changes of pregnancy and to know the proportion of these cutaneous manifestations in pregnant women. Methods This study included 600 pregnant women attending the Obstetrics and Gynecology Department of a tertiary teaching hospital in Northern Kerala, India. Detailed history elicitation and complete physical and dermatological examination were performed. Skin biopsy was performed in relevant cases. Results Cutaneous changes were seen in a majority of patients, of which physiological changes were the most common (99%). The most common cutaneous manifestation was hyperpigmentation (526; 87.6%), followed by striae gravidarum (72.8%). Other changes were vascular, including pedal edema (10%), pregnancy gingivitis (1.8%), and varicose veins (1%). Infections were the common dermatological problem in this study group. The most common infections were vulvovaginal candidiasis (21%), Tinea versicolor (6%), scabies (2.8%), dermatophytosis (1.5%), and sexually transmitted infection (0.5%). Specific dermatoses were seen in 12 cases (2%), with the most common being pruritic urticarial papules and plaques of pregnancy (1.3%). Conclusion Pregnant women are prone to suffer from a wide range of dermatological problems apart from specific dermatoses of pregnancy. The study emphasizes the need for a detailed and meticulous examination of these patients to detect these various disorders. [ABSTRACT FROM AUTHOR]

Psoriasis is an inflammatory skin disorder not uncommonly seen in pregnant patients. Several drugs have been approved for its treatment in non-pregnant patients, but special precautions are necessary when selecting a treatment plan during pregnancy to prevent harm to the fetus and child. This article reviews the treatment options for the treatment of psoriasis in the pregnant and lactating patient. [ABSTRACT FROM AUTHOR]

Abstract: Normal pregnancy is characterized by a natural homeostasis between the mother and the fetus with the development of a tolerance for genetically and immunologically different tissues engrafted in the maternal organism. Upset of the fine mechanisms of the balance of this homeostasis leads to the development of different diseases. Pemphigoid gestationis is a self-limiting, autoimmune subepidermal bullous dermatosis of pregnancy that results from the recognition of placental proteins as foreign and the subsequent production of anti-placental antibodies that cross-react with the same proteins in skin. The main antigen of PG was found to be collagen XVII, present in both skin and placenta, that is exposed to the maternal immune system through an abnormal expression of MHC class II molecules in the placenta. The genetic predisposition determined by a specific HLA genotype combined with the aberrant presentation of collagen XVII triggers an inflammatory response resulting in the typical clinical phenotype. Immunofluorescence shows a linear deposition of C3 with or without concomitant IgG deposition, along the basement membrane zone (BMZ). The disease usually resolves within weeks to months after delivery and tends to recur with subsequent pregnancies. Treatment is challenging in that the disease is extremely rare to allow for controlled studies and most of the treatment options are based on case reports and clinical experience. Oral corticosteroids are the therapeutic mainstay both in pregnancy and postpartum, but several other modalities may be tried in recalcitrant disease. Further research is needed to clarify the exact pathogenic cascade and the interaction of its different components. The elucidation of the target antigens, the targeting antibodies and the mechanism of action of the inflammatory infiltrate may help for the development of new focused therapeutic agents. This review presents an overview of the current understanding of Pemphigoid gestationis and the latest scientific and clinical data in relation to the pathogenesis and treatment modalities. [Copyright &y& Elsevier]

The 17th Congress of the European Academy of Dermatology and Venereology took place in Paris on 17–20 September 2008 and brought together nearly 11 000 participants. Various plenary lectures, subspecialty meetings, ‘free communications’, ‘top ten’, ‘test yourself’ and ‘junior’ sessions, 19 courses and 14 ‘lunches with the expert’, six forums, 27 symposia and 45 workshops were pressed into the 4 days of the meeting. Over 1700 posters were presented and exhibited. The themes of a number of symposiums, workshops and sessions overlapped, offering additional educational opportunities despite a very busy schedule. The meeting was well organized. Aesthetic dermatology comprised a significant part of the meeting. It is impossible to encompass all important presentations and we highlight a few medical pearls presented at the meeting; however, our report is not intended as a substitute for reading the conference proceedings and related references quoted in this article. [ABSTRACT FROM AUTHOR]

Background: During pregnancy profound immunologic, metabolic, endocrine and vascular changes occur, that are responsible for the changes of the skin and its appendages, both physiologic and pathologic. Aims: We undertook a clinical study to find out the frequency and pattern of skin changes in pregnant women. Methods: All consecutive pregnant women were included in the study. Results: A total of 607 pregnant women were included in this study. Of these, 303(49.9%) pregnant women were primigravida and 304(51.1%) were multigravida. Skin changes grouped into: physiological changes (all cases), specific dermatoses (22 cases) and other dermatoses affected by pregnancy (125 cases). Most common physiological changes were pigmentary alterations seen in 555 (91.4%) followed by striae seen in 484(79.7%) cases. Of the various specific dermatoses of pregnancy, pruritic urticarial papules and plaques of pregnancy (PUPPP) was the most common disorder (14 cases) followed by pruritus gravidarum (5 cases). The most common dermatoses affected by pregnancy were candidal vaginitis (17 cases), acne vulgaris (15 cases), skin tags (15 cases), eczemas (14 cases). Conclusion: This study brings into focus various skin changes during pregnancy in south India. [ABSTRACT FROM AUTHOR]

Pemphigoid gestationis (PG), also known as gestational pemphigoid, as it is specifically associated with a pregnancy event, is among the rare pregnancy-related dermatoses, characterised by the formation of autoantibodies against Bullous Pemphigoid antigens 180 and 230 (BP180 and BP230), causing significant damage to the basement membrane of the skin, resulting in marked pruritus and blisters on the abdomen and extremities. Diagnosis of PG is basically made by the characteristic clinical picture and confirmed by immunofluorescence studies and histopathology of a skin biopsy. Treatment, just as for other autoimmune dermatoses, is achieved by corticosteroids with the risk of relapses in subsequent pregnancies. Fetal growth restriction and pre-maturity are potential fetal complications associated with the disease, hence the recommended combined antenatal care by a dermatologist as well as an obstetrician, however, this disease is unlikely to be a source of significant maternal morbidity or mortality., Competing Interests: Declaration of Competing Interest We declare no competing interests of the authors, (Copyright © 2022 Elsevier Masson SAS. All rights reserved.)

Objectives: The aim of the study was to investigate the prevalence of self-reported skin complaints during pregnancy, applied treatment and the impact on well-being of pregnant women., Material and Methods: We asked 1935 women that were maximum 4 years after labor to fill in our questionnaire. The questionnaire included questions concerning the course of pregnancy, observed skin lesions, applied treatment and influence on the quality of life., Results: Skin changes during pregnancy were reported by 1447 patients (74.78%). The prevalence of self-reported skin complaints were as follows: stretch marks (77.4%), acne (21.6%) and recurrent herpes labialis (11.6%). In 43.67% (n = 632) of women who reported dermatological problems during pregnancy the disease caused significant deterioration in their well-being. Only 168 patients (11.61%) received dermatological treatment from their obstetricians. Dermatological con-sultation required 217 patients (14.99%). For 133 of treated women (25.68%) the recommended treatment was expensive. However, in the majority of patients (379; 73.15%) who received treatment the skin changes resolved after therapy. Skin symptoms resolved significantly faster in the treated group (3.5 ± 4.3 week vs 5.8 ± 6.2 week; p < 0.001)., Conclusions: Self-reported skin complaints seem to be a relevant problem during pregnancy. Proper skin care as well as appropriate treatment applied by obstetricians and/or dermatologists may help women to recover.