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Abdelhafez MMA, Ahmed KAM, Mohd Daud MNB, Jeffree MS, Kadir F, Baharuddin DMP, Than WW, Hayatti F, Tay KX, Eldiastey AM. Impetigo herpetiformis: A rare pregnancy-specific dermatosis. Obstet Med 2023; 16:5-8. [PMID: 37139500 PMCID: PMC10150312 DOI: 10.1177/1753495x221074610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/18/2021] [Accepted: 01/02/2022] [Indexed: 11/15/2022] Open
Abstract
Impetigo herpetiformis (IH) is a pregnancy-specific dermatosis that is currently considered a form of generalised pustular psoriasis and mainly occurs in late pregnancy during the third trimester. IH presents as erythematous patches and pustules and might have systemic involvement. The disease may be associated with severe maternal, fetal, and neonatal complications. IH treatment is very challenging, however, various therapeutic options are available and effective for disease treatment.
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Affiliation(s)
- Mohsen M. A. Abdelhafez
- Department of Obstetrics and Gynaecology,
Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Malaysia
| | - Karim A. M. Ahmed
- Department of Dermatology, Helios Saint Johannes Klinikum, Duisburg, Germany
| | - Mohd Nazri Bin Mohd Daud
- Family Medicine Unit, Department of Public
Health Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Malaysia
| | - Mohammad Saffree Jeffree
- Department of Public Health Medicine, Faculty
of Medicine and Health Sciences, Universiti Malaysia Sabah, Malaysia
| | - Fairrul Kadir
- Department of Emergency Medicine, Faculty of
Medicine and Health Sciences, Universiti Malaysia Sabah, Malaysia
| | - Dg Marshitah pg Baharuddin
- Department of Obstetrics and Gynaecology,
Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Malaysia
| | - Win Win Than
- Department of Obstetrics and Gynaecology,
Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Malaysia
| | - Firdaus Hayatti
- Department of Surgery, Faculty of Medicine
and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Kai Xin Tay
- Faculty of Business, Economic, and
Accountancy, Universiti Malaysia Sabah, Malaysia
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2
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Casaril A, Ducarme G. [Dermatologic diseases and healthcare pathway among pregnant women]. GYNECOLOGIE, OBSTETRIQUE, FERTILITE & SENOLOGIE 2023; 51:129-133. [PMID: 36623706 DOI: 10.1016/j.gofs.2022.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 12/20/2022] [Accepted: 12/23/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Make an inventory of skin lesions during pregnancy and obtain visibility on healthcare pathway among these women in order to identify more precisely the role of the general practitioner (GP). METHODS Prospective, observational study, using a self-administered questionnaire among all women in immediate postpartum period between April 2021 and August 2021, relating to pre-existing skin lesions or rashes that appeared during pregnancy, and the description of the healthcare pathway among these women. RESULTS The questionnaire was collected in 377 women with a mean age of 30.6±3.7 years, 88.6% had fair skin and 14.6% were smokers. Among them, 35 (9.3%) declared skin diseases prior to pregnancy, of which 22 had a history of atopic eczema. During pregnancy, 136 women (36.1%) declared having skin lesions, the most frequent of which were stretch marks (63.2%) and hyperpigmentation (26.5%), and mainly during the 2nd trimester (47.0%). Among these 136 women, only 59 (43.4%) referred it to a health care professional who was in 47.4% of cases (28/59) their GP and in 76.3% (45/59) of cases during a pregnancy follow-up appointment. CONCLUSION This study showed that skin lesions during pregnancy were frequent and that the majority of these women consulted their GP.
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Affiliation(s)
- A Casaril
- Service de gynécologie obstétrique, centre hospitalier départemental vendée, 85000 La Roche sur Yon, France
| | - G Ducarme
- Service de gynécologie obstétrique, centre hospitalier départemental vendée, 85000 La Roche sur Yon, France.
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Anzelc MJ, Bechtel MA. Considerations for cutaneous physiologic changes of pregnancy that fail to resolve postpartum. Int J Dermatol 2023; 62:190-196. [PMID: 35132624 DOI: 10.1111/ijd.16105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 11/03/2021] [Accepted: 01/05/2022] [Indexed: 01/20/2023]
Abstract
Pregnancy prompts many adaptive and unique physiologic modifications, with cutaneous changes being possibly the most noticeable. These cutaneous changes are of interest to physicians, since they must be diagnosed as anticipated normal physiologic changes or potentially harmful and managed accordingly. Research has been conducted on physiologically normal and abnormal cutaneous manifestations of pregnancy but is lacking in regard to the persistence of these changes after delivery. This prompts the question as to whether these are normal physiologic changes taking longer to resolve, abnormal changes that may have been previously misdiagnosed, or a separate underlying change that is incorrectly attributed to a common dermatosis caused by pregnancy. Some of the conditions that may persist longer than expected during or after pregnancy, and thus require further workup for an underlying condition, include telogen effluvium, severe hirsutism, palmar erythema, and striae. The objective of this review is to focus on these four common cutaneous physiologic changes of pregnancy, and what to consider when they do not resolve as expected.
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Affiliation(s)
- Madison J Anzelc
- Medical Researcher, Department of Medicine, Division of Dermatology, University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA
| | - Mark A Bechtel
- Professor of Medicine, Director of Dermatology, The Ohio State University College of Medicine, Columbus, OH, USA
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Diagnostic Pitfall in Atypical Febrile Presentation in a Patient with a Pregnancy-Specific Dermatosis—Case Report and Literature Review. Medicina (B Aires) 2022; 58:medicina58070847. [PMID: 35888566 PMCID: PMC9315689 DOI: 10.3390/medicina58070847] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 06/22/2022] [Accepted: 06/24/2022] [Indexed: 12/04/2022] Open
Abstract
Pruritic urticarial papules and plaques of pregnancy (PUPPP) usually occurs in the third trimester of pregnancy in primiparous women. It is a self-limiting inflammatory disorder with a still unknown pathogenic mechanism. The abdominal wall overdistension, with a subsequent inflammatory response due to damage to the connective tissue, represents a pathogenesis explanation. Clinical features involve intensely pruritic urticarial rash with edematous, erythematous papules and plaques. The clinical picture and dermal biopsy establish the diagnosis. Topical corticosteroids and oral antihistamines are usually sufficient, but sometimes systemic corticosteroids are necessary. Maternal and fetal prognosis is excellent, and the lesions resolve after birth with no scarring or pigmentary change. We present a case of a 36-year-old patient with a 32-week pregnancy who was admitted with a generalized pruritic rash accompanied by fever. The final diagnosis was decided after multiple pathology exclusions. Treatment consisted of systemic corticoid therapy. The patient gave birth by cesarean section to a healthy newborn without dermatological lesions or other conditions. Adding more PUPPP cases to the literature portfolio will bring more awareness to this under-recognized and under-reported skin disorder. We trust this case will encourage other physicians to publish more cases of pregnancy-specific dermatoses.
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Pemphigoid Gestationis and adverse pregnancy outcomes: A Literature review. J Gynecol Obstet Hum Reprod 2022; 51:102370. [DOI: 10.1016/j.jogoh.2022.102370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 03/24/2022] [Accepted: 03/31/2022] [Indexed: 11/23/2022]
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Ceryn J, Siekierko A, Skibińska M, Doss N, Narbutt J, Lesiak A. Pemphigoid Gestationis - Case Report and Review of Literature. Clin Cosmet Investig Dermatol 2021; 14:665-670. [PMID: 34168478 PMCID: PMC8218239 DOI: 10.2147/ccid.s297520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 03/18/2021] [Indexed: 12/14/2022]
Abstract
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.
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Affiliation(s)
- Justyna Ceryn
- Department of Dermatology, Pediatric Dermatology and Oncology Clinic, Medical University of Lodz, Lodz, Poland
| | - Aleksandra Siekierko
- Department of Dermatology, Pediatric Dermatology and Oncology Clinic, Medical University of Lodz, Lodz, Poland
| | - Małgorzata Skibińska
- Department of Dermatology, Pediatric Dermatology and Oncology Clinic, Medical University of Lodz, Lodz, Poland
| | - Nejib Doss
- Golden Towers Medical Center, Centre Urbain Nord, Tunis, 1082, Tunisia
| | - Joanna Narbutt
- Department of Dermatology, Pediatric Dermatology and Oncology Clinic, Medical University of Lodz, Lodz, Poland
| | - Aleksandra Lesiak
- Department of Dermatology, Pediatric Dermatology and Oncology Clinic, Medical University of Lodz, Lodz, Poland
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Oropeza Chávez L, Sánchez Tinajero Á, Martínez Orozco JA, Becerril Vargas E, Dolores De la Merced A, Ruíz Santillán DP, Delgado Cueva AI, Alvarado Peña N. A 34-Year-Old Woman with a Diamniotic Dichorionic Twin Pregnancy Presenting with an Erythematous and Papular Skin Rash Associated with SARS-CoV-2 Infection. AMERICAN JOURNAL OF CASE REPORTS 2021; 22:e929489. [PMID: 33743006 PMCID: PMC7990122 DOI: 10.12659/ajcr.929489] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Patient: Female, 34-year-old Final Diagnosis: COVID-19 • Pregnacy Symptoms: Earache • fatigue • odynophagia Medication: — Clinical Procedure: Cesarean Specialty: Infectious Diseases • Microbiology and Virology • Obstetrics and Gynecology
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Affiliation(s)
| | - Ángel Sánchez Tinajero
- Department of Infectious Diseases, National Institute of Respiratory Diseases (INER), Mexico City, Mexico
| | | | - Eduardo Becerril Vargas
- Department of Laboratory of Clinical Microbiology, National Institute of Respiratory Diseases (INER), Mexico City, Mexico
| | | | | | - Andrea Iraís Delgado Cueva
- Department of Infectious Diseases, National Institute of Respiratory Diseases (INER), Mexico City, Mexico
| | - Nestor Alvarado Peña
- Department of Infectious Diseases, National Institute of Respiratory Diseases (INER), Mexico City, Mexico
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Yang M, Zhou M, Li Y, Huang H, Jia Y. Lipidomic analysis of facial skin surface lipid reveals the causes of pregnancy-related skin barrier weakness. Sci Rep 2021; 11:3229. [PMID: 33547383 PMCID: PMC7864992 DOI: 10.1038/s41598-021-82624-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 01/18/2021] [Indexed: 12/17/2022] Open
Abstract
Self-reported skin discomfort is a common problem during pregnancy, but it is not clear whether skin barrier function is altered in the process. Few studies have described the skin barrier function during pregnancy. In this work, we used highly sensitive and high-resolution ultra performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UPLC-QTOF-MS) to distinguish skin surface lipid (SSL) combined with multivariate analysis of lipids and metabolic changes to determine the relationship between SSL changes and skin physiology during pregnancy in order to better understand the skin condition of pregnant women. The results showed a significant reduction in the total lipid content in pregnant women. A total of 2270 lipids were detected, and the relative abundances of fatty acyls and glycerolipids were significantly reduced, while glycerophospholipids (GPs), sphingolipids, and saccharolipids was significantly increased in the pregnancy group. Multivariate data analysis indicated that 23 entities constituted the most important individual species responsible for the discrimination and phosphatidylcholine was the most abundant lipid in pregnancy group. In addition, compared to SSL profile of control group, it was observed that the average chain length of ceramides and fatty acids both decreased in SSL profile of pregnancy group. The main and most commonly affected pathway was that of GP pathways. These findings indicate that skin lipids are significantly altered in mid-pregnancy compared to the control group. Changes in ostrogen during pregnancy also make the skin more susceptible to inflammatory factors and lead to more fragile and susceptible skin, weakening the skin barrier along with the lipid alterations.
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Affiliation(s)
- Manli Yang
- Beijing Key Laboratory of Plant Resources Research and Development, College of Chemistry and Materials Engineering, Beijing Technology and Business University, Beijing, 100048, China.,Key Laboratory of Cosmetic of China National Light Industry, College of Chemistry and Materials Engineering, Beijing Technology and Business University, Beijing, 100048, China
| | - Mingyue Zhou
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, China
| | - Yuan Li
- Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Hong Huang
- Department of Gynecology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Yan Jia
- Beijing Key Laboratory of Plant Resources Research and Development, College of Chemistry and Materials Engineering, Beijing Technology and Business University, Beijing, 100048, China. .,Key Laboratory of Cosmetic of China National Light Industry, College of Chemistry and Materials Engineering, Beijing Technology and Business University, Beijing, 100048, China.
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Maglie R, Quintarelli L, Verdelli A, Fabbri P, Antiga E, Caproni M. Specific dermatoses of pregnancy other than pemphigoid gestationis. GIORN ITAL DERMAT V 2018; 154:286-298. [PMID: 30375214 DOI: 10.23736/s0392-0488.18.06159-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Specific dermatoses of pregnancy are skin disorders that occur specifically during or immediately after pregnancy and cannot be found in non-pregnant patients. According to the current consensus, they include atopic eruption of pregnancy (AEP), polymorphic eruption of pregnancy (PEP), pemphigoid gestationis (PG), and intrahepatic cholestasis of pregnancy (ICP). The diagnosis of specific dermatoses of pregnancy can be challenging due to their variation in clinical presentation; moreover, the tests currently available do not always provide the clue for the diagnosis. However, some distinctive features may be helpful to differentiate between such entities. Accordingly, the knowledge of specific dermatoses of pregnancy and of their management is critical, since their early recognition may allow to provide care for the mother and prevent potential increased fetal risk. In fact, while AEP and PEP do not affect maternal and fetal prognosis, PG and, mainly, ICP are associated to maternal complications as well as the risk of fetal loss. In this paper, the epidemiology, pathogenesis, clinical features as well as management of AEP and PEP are reviewed in detail, while PG is described in another article of this issue. Moreover, the main features of ICP, which cannot be considered a primarily skin disease but may be managed first by dermatologists, are reported.
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Affiliation(s)
- Roberto Maglie
- Section of Dermatology, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
| | - Lavinia Quintarelli
- Section of Dermatology, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
| | - Alice Verdelli
- Section of Dermatology, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
| | - Paolo Fabbri
- Section of Dermatology, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
| | - Emiliano Antiga
- Section of Dermatology, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy -
| | - Marzia Caproni
- Section of Dermatology, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
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Phungpanya C, Chaipuang A, Machan T, Watla-iad K, Thongpoon C, Suwantong O. Synthesis of prednisolone molecularly imprinted polymer nanoparticles by precipitation polymerization. POLYM ADVAN TECHNOL 2018. [DOI: 10.1002/pat.4428] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Chalida Phungpanya
- School of Science; Mae Fah Luang University; Chiang Rai 57100 Thailand
- Center of Chemical Innovation for Sustainability; Mae Fah Luang University; Chiang Rai 57100 Thailand
| | - Angkana Chaipuang
- School of Science; Mae Fah Luang University; Chiang Rai 57100 Thailand
- Center of Chemical Innovation for Sustainability; Mae Fah Luang University; Chiang Rai 57100 Thailand
| | - Theeraphan Machan
- School of Science; Mae Fah Luang University; Chiang Rai 57100 Thailand
- Center of Chemical Innovation for Sustainability; Mae Fah Luang University; Chiang Rai 57100 Thailand
| | - Kanchana Watla-iad
- School of Science; Mae Fah Luang University; Chiang Rai 57100 Thailand
- Center of Chemical Innovation for Sustainability; Mae Fah Luang University; Chiang Rai 57100 Thailand
| | - Chalermporn Thongpoon
- Program of Chemistry, Faculty of Science and Technology; Pibulsongkram Rajabhat University; Phitsanulok 65000 Thailand
| | - Orawan Suwantong
- School of Science; Mae Fah Luang University; Chiang Rai 57100 Thailand
- Center of Chemical Innovation for Sustainability; Mae Fah Luang University; Chiang Rai 57100 Thailand
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Abstract
Many skin diseases can occur in pregnant women. However, a few pruritic dermatological conditions are unique to pregnancy, including pemphigoid gestationis (PG). As PG is associated with severe morbidity for pregnant women and carries fetal risks, it is important for the clinician to quickly recognize this disease and refer it for dermatological evaluation and treatment. Herein, we review the pathogenesis, clinical characteristics, and management of PG.
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Affiliation(s)
| | - Freja Lærke Sand
- Department of Dermatology, Bispebjerg Hospital, Copenhagen, Denmark
| | - Simon Francis Thomsen
- Department of Dermatology, Bispebjerg Hospital, Copenhagen, Denmark.,Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
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12
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Motosko CC, Bieber AK, Pomeranz MK, Stein JA, Martires KJ. Physiologic changes of pregnancy: A review of the literature. Int J Womens Dermatol 2017; 3:219-224. [PMID: 29234716 PMCID: PMC5715231 DOI: 10.1016/j.ijwd.2017.09.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Revised: 09/17/2017] [Accepted: 09/17/2017] [Indexed: 01/25/2023] Open
Abstract
Throughout pregnancy, the body undergoes a variety of physiologic changes. The cutaneous findings can be most noticeable and often worrisome to both physicians and patients. Obstetricians and dermatologists must be able to differentiate between changes that are benign and those that may be pathologic. Most physicians recognize benign changes that are commonly described in literature such as hyperpigmentation, melasma, striae gravidarum, and telogen effluvium; however, they may be unaware of changes that tend to be less frequently discussed. This comprehensive review provides a broad overview of the physiologic cutaneous changes that occur during pregnancy as described in the literature over the past 10 years.
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Affiliation(s)
- Catherine C Motosko
- Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, NY
| | - Amy Kalowitz Bieber
- Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, NY
| | - Miriam Keltz Pomeranz
- Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, NY
| | - Jennifer A Stein
- Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, NY
| | - Kathryn J Martires
- Department of Dermatology, Stanford University School of Medicine, Redwood City, CA
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Abstract
Impetigo, a bacterial skin infection that involves the superficial layers of the skin, is one of the most common skin infections in children ages 2 to 5 but can occur in individuals across the lifespan. This article discusses the diagnosis and management of impetigo in primary care.
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Affiliation(s)
- Kathy VanRavenstein
- Kathy VanRavenstein is an instructor at the Medical University of South Carolina, College of Nursing, Charleston, S.C. Whitney Smith is an instructor at the Medical University of South Carolina, College of Nursing, Charleston, S.C. Catherine O'Connor Durham is an assistant professor at the Medical University of South Carolina, College of Nursing, Charleston, S.C. Tiffany H. Williams is an assistant professor at the Medical University of South Carolina, College of Nursing, Charleston, S.C
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14
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Mehta N, Chen KK, Kroumpouzos G. Skin disease in pregnancy: The approach of the obstetric medicine physician. Clin Dermatol 2016; 34:320-6. [DOI: 10.1016/j.clindermatol.2016.02.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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