The specific dermatoses of pregnancy revisited and reclassified: Results of a retrospective two-center study on 505 pregnant patients Christina M. Ambros-Rudolph,

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Presentation transcript:

The specific dermatoses of pregnancy revisited and reclassified: Results of a retrospective two-center study on 505 pregnant patients Christina M. Ambros-Rudolph, MD, Robert R. Müllegger, MD, Samantha A. Vaughan-Jones, MD, Helmut Kerl, MD, Martin M. Black, MD, FRCP, FRCPath Journal of the American Academy of Dermatology Volume 54, Issue 3, Pages 395-404 (March 2006) DOI: 10.1016/j.jaad.2005.12.012 Copyright © 2006 American Academy of Dermatology, Inc. Terms and Conditions

Fig 1 Atopic eruption of pregnancy in 31-year-old woman presenting at 23 weeks gestation of her first pregnancy. A, Maculopapular rash involves abdomen, breasts, and flexural parts of limbs (B). Patient has history of mild childhood eczema and positive family history of atopy in one first-degree relative. Journal of the American Academy of Dermatology 2006 54, 395-404DOI: (10.1016/j.jaad.2005.12.012) Copyright © 2006 American Academy of Dermatology, Inc. Terms and Conditions

Fig 2 Polymorphic eruption of pregnancy in 28-year-old primigravida with postpartum onset 3 days after delivery. A, Conspicuous, dark red striae distensae on abdomen are accompanied by pruritic urticarial papules and plaques, which also involve her legs (B). Journal of the American Academy of Dermatology 2006 54, 395-404DOI: (10.1016/j.jaad.2005.12.012) Copyright © 2006 American Academy of Dermatology, Inc. Terms and Conditions

Fig 3 Pemphigoid gestationis in 34-year-old primigravida at 28 weeks gestation. A, Urticated erythema with multiple tense blisters on both thighs. B, Histopathologic findings reveal subepidermal blister formation with abundant eosinophils, accompanied by superficial and middermal perivascular lymphohistiocytic infiltrate. (Hematoxylin-eosin stain; original magnification: ×10.) C, Direct immunofluorescence examination of perilesional skin shows bright linear staining with C3 at basement membrane. Journal of the American Academy of Dermatology 2006 54, 395-404DOI: (10.1016/j.jaad.2005.12.012) Copyright © 2006 American Academy of Dermatology, Inc. Terms and Conditions

Fig 4 Intrahepatic cholestasis of pregnancy in 25-year-old primigravida at 32 weeks gestation. Excoriated papules and scratch marks on shins after severe pruritus caused by elevated total serum bile acids (47 μmol/L; normal, <6 μmol/L). Journal of the American Academy of Dermatology 2006 54, 395-404DOI: (10.1016/j.jaad.2005.12.012) Copyright © 2006 American Academy of Dermatology, Inc. Terms and Conditions

Fig 5 Algorithm for differential diagnosis of pruritic skin diseases in pregnancy. AEP, Atopic eruption of pregnancy; DEJ, dermoepidermal junction; H&E, hematoxylin-eosin; ICP, intrahepatic cholestasis of pregnancy; IMF, immunofluorescence microscopy; LAB, laboratory investigations; PEP, polymorphic eruption of pregnancy; PG, pemphigoid gestationis; PP, postpartum. Journal of the American Academy of Dermatology 2006 54, 395-404DOI: (10.1016/j.jaad.2005.12.012) Copyright © 2006 American Academy of Dermatology, Inc. Terms and Conditions