Pregnancy related rashes Flashcards
(17 cards)
What is polymorphic eruption of pregnancy?
An itchy rash which tends to start in the third trimester which usually begins on the abdomen.
What is polymorphic eruption of pregnancy characterised by?
Urticarial papules, wheals, plaques; lesions can often first appear in abdominal striae and usually spare the periumbilical area.
What is the management of polymorphic eruption of pregnancy?
Gets better towards end of pregnancy and after delivery. Topical emollients, topical steroids (mild potency), oral antihistamines, oral steroids in severe cases.
What is atopic eruption of pregnancy?
Commonest skin disorder found in pregnancy; refers to eczema which flares up in first and second trimester and can include women with previous eczema and people with no previous eczema.
What are the two types of atopic eruption of pregnancy?
E type or eczema type: eczematous, inflamed, red & itchy skin which typically affects insides of elbows, back of knees, neck, face & chest. P type or prurigo type: intensely itchy papules typically affecting the abdomen, back & limbs.
What is the management of atopic eruption?
Gets better after delivery. Topical emollients, topical steroids, phototherapy with UV light (UVB) in severe cases, oral steroids in severe cases.
What is melasma?
Also known as ‘mask of pregnancy’; increased pigmentation to patches of the skin on the face which is usually symmetrical & flat, affecting sun exposed areas.
What causes melasma?
Thought to be related to the increased female sex hormones associated with pregnancy; can also occur with COCP and HRT.
What is the management of melasma?
No active treatment if the woman is okay with it. Avoid sun exposure & suncream, makeup (camouflage), skin lightning cream (hydroquinone or retinoids) but NOT until after pregnancy under specialist care, procedures such as chemical peels or laser treatments (not on NHS).
What is pyogenic granuloma?
Also known as lobular capillary haemangioma; a benign, rapidly growing tumour of capillaries which presents as a discrete lump with a red or dark appearance and occurs more in pregnancy.
How and where does a pyogenic granuloma present?
A rapidly growing lump that develops over days up to 1-2cm in size which often occurs on fingers or on the upper chest, back, neck or head and can cause profuse bleeding & ulceration if injured.
What are other differentials which need to be excluded in pyogenic granuloma?
Nodular melanoma; when they occur in pregnancy they usually resolve without treatment after delivery but treatment is with surgical removal with histology to confirm the diagnosis.
What is pemphigoid gestationis?
A rare autoimmune skin condition which occurs in pregnancy.
What is the pathophysiology of pemphigoid gestationis?
Autoantibodies are created that damages the connection between the epidermis & dermis; the pregnant woman’s immune system may produce these antibodies in response to placental tissue which causes the epidermis & dermis to separate, creating a space that can fill with fluid.
What is the typical presentation of pemphigoid gestationis?
Usually occurs in second or third trimester; itchy red papular or blistering rash around the umbilicus that then spreads to other parts of the body and over several weeks, large fluid filled blisters form.
What is the management of pemphigoid gestationis?
Usually resolves after delivery without treatment and the blisters heal without scarring. Topical emollients, topical steroids, oral steroids in severe cases, immunosuppressants may be required where steroids are inadequate, antibiotics may be necessary if infection occurs.
What are the risks to the baby in terms of pemphigoid gestationis?
Fetal growth restriction, preterm delivery, blistering rash after delivery (as the maternal antibodies pass to the baby).
