Podcast Beta
Questions and Answers
What are the most common physiologic changes in pregnancy?
Pemphigoid (Herpes Gestationis) is common during pregnancy.
False
What condition is characterized by irregular, blotchy facial hyperpigmentation during pregnancy?
Melasma/Chloasma
Pemphigoid manifests as abrupt appearance of severely pruritic urticarial lesions on a background of __________ skin.
Signup and view all the answers
During which trimester does Pemphigoid typically begin?
Signup and view all the answers
What potential outcomes are associated with Pemphigoid during pregnancy?
Signup and view all the answers
What is the immunologic characteristic seen in Pemphigoid?
Signup and view all the answers
Pemphigoid can only occur in normal pregnancies.
Signup and view all the answers
What are some risk factors associated with Dermatitis of Pregnancy (DIP)?
Signup and view all the answers
IDIF test is positive in cases of Dermatitis of Pregnancy.
Signup and view all the answers
What is the average duration of pregnancy when Dermatitis of Pregnancy typically occurs?
Signup and view all the answers
The most common pruritic disorder in pregnancy is _____ .
Signup and view all the answers
What type of skin changes are characteristic of Atopic Eruption of Pregnancy?
Signup and view all the answers
Which laboratory test results can indicate atopic dermatitis in pregnancy?
Signup and view all the answers
Match the following treatments of Dermatitis of Pregnancy with their purposes:
Signup and view all the answers
What is the clinical prognosis for mothers with a history of atopy during pregnancy?
Signup and view all the answers
Which of the following is a typical feature of polymorphic eruption of pregnancy?
Signup and view all the answers
Melasma may regress postpartum but often persists.
Signup and view all the answers
What are the common areas affected by stretch marks in pregnancy?
Signup and view all the answers
Which test is considered the gold standard for diagnosing Intrahepatic Cholestasis of Pregnancy (ICP)?
Signup and view all the answers
The degree of pruritus correlates with ___ concentration in ICP.
Signup and view all the answers
What is the typical prognosis for maternal health in cases of Intrahepatic Cholestasis of Pregnancy?
Signup and view all the answers
What is the most feared complication of Intrahepatic Cholestasis of Pregnancy?
Signup and view all the answers
Pustular psoriasis of pregnancy generally has higher incidence rates during winter months.
Signup and view all the answers
Match the following conditions with their defining characteristics.
Signup and view all the answers
Study Notes
Skin Changes in Pregnancy
- Pregnancy induces altered endocrine, metabolic, and immunologic environments, leading to various skin changes.
- Common pigmentary disturbances include:
- Linea Nigra: Darkening of the linea alba, reversible post-pregnancy.
- Melasma/Chloasma: Irregular facial hyperpigmentation occurs in 70% of pregnancies, worsened by sun exposure and oral contraceptive use.
- Structural changes:
- Striae gravidarum (stretch marks) primarily affect the abdomen, hips, buttocks, and breasts.
- Common vascular changes include spider angiomas.
Dermatoses with Fetal Risk
Pemphigoid (Herpes Gestationis)
- Rare condition, seen in 1 in 50,000 pregnancies, occurs in mid-to-late pregnancy and postpartum.
- Characterized by pruritic urticarial lesions; may lead to small-for-gestational age and premature deliveries.
- Immunologically mediated with diagnostic features including:
- DIF showing linear deposition of C3 and IgG.
- Elevated serum bile acids indicating Intrahepatic Cholestasis of Pregnancy (ICP).
Intrahepatic Cholestasis of Pregnancy (ICP)
- Rare and reversible cholestasis typically arises in late pregnancy due to high estrogen levels.
- Symptoms include severe pruritus, especially localized to palms and soles in the third trimester.
- Correlates with increased risk of fetal complications: prematurity, fetal distress, stillbirth.
- Diagnosed through elevated serum bile acids and liver function tests.
- Management may involve UDCA (ursodeoxycholic acid) to lower bile acid levels and improve symptoms.
Pustular Psoriasis of Pregnancy (Impetigo Herpetiformis)
- Very rare variant of pustular psoriasis occurring in the third trimester but can onset as early as the first trimester.
- Characterized by erythematous patches with subcorneal pustules, often associated with constitutional symptoms like fever and malaise.
- Diagnosis includes CBC with leukocytosis, careful consideration of differential diagnoses such as pemphigoid gestationis.
Dermatoses Not Associated with Fetal Risk
Polymorphic Eruption of Pregnancy
- A common, benign condition typically seen in primagravida, presenting in the third trimester.
- Etiology remains unknown; pathogenesis may involve maternal immunoreactivity linked to abdominal distention.
- Clinically diagnosed based on typical presentation and locations at the end of pregnancy, with biopsy reserved for uncertain cases.### Developmental Inflammatory Dermatitis (DIF) and PEP
- Increased progesterone receptor noted in lesional PEP.
- Granular or absent C3, IgM, or IgA at the dermoepidermal junction, particularly around blood vessels.
- IDIF is negative in most cases.
- Multiple gestations (twins and triplets) identified as a risk factor.
- Unexplained associations with male fetuses and cesarean sections.
- Increased maternal-fetal weight gain also noted.
- Harmless to mother and fetus, but pruritus observed to be intense and unremitting.
- Symptomatic relief can be achieved through various treatment options.
Cutaneous Findings in PEP
- Typically seen in primagravids during the last trimester, average at 35 weeks.
- Presents as polymorphous erythematous urticarial papules with a narrow pale halo.
- Eruptions often begin in the abdomen (notably in the striae gravidarum) and have periumbilical sparing, spreading to thighs, buttocks, breasts, and arms.
- Severe pruritus may interfere with sleep patterns.
Atopic Eruption of Pregnancy (AEP)
- Most common pruritic skin disorder in pregnancy; occurs in about 50% of all pregnancies.
- Pregnancy influences cytokine profiles, favoring T-helper 2 cell expression.
- Personal or family history of atopy is a significant risk factor.
- Clinical manifestations include flare-ups in 20% of patients with preexisting atopic dermatitis.
Subtypes of AEP
- E-type (Eczematous): Typically affects flexural surfaces and face.
- P-type (Popular): Involves individuals with atopic backgrounds or elevated serum IgE levels, presenting as prurigo of pregnancy with itchy, excoriated papules mainly on extensor surfaces.
Diagnosis of AEP
- Diagnosis determined clinically and supported by histopathology, which appears nonspecific.
- Laboratory tests typically show elevated total serum IgE in 20-70% of cases.
Clinical Course and Prognosis
- Onset usually occurs in the third trimester and generally responds well to therapy.
- Prognosis for both mother and fetus is excellent.
- Infants of mothers with a history of atopy have an increased risk for developing atopic dermatitis.
Treatment and Management of AEP
- Emollients recommended for skin hydration.
- Midpotency topical corticosteroids are commonly used.
- Antihistamines can be given to control itching.
- Benzoyl peroxide may be used for truncal, follicular, and non-viral bullae.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Related Documents
Description
This quiz explores the common physiologic changes during pregnancy, including conditions such as Pemphigoid (Herpes Gestationis) and facial hyperpigmentation. Test your knowledge on the symptoms, outcomes, and typical timelines associated with these conditions in expectant mothers. Get ready to deepen your understanding of pregnancy-related physiological changes.
