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SKIN and PREGNANCY

SKIN and PREGNANCY. By Dr M. Y.Abd El-Mawla,MD Zagazig Faculty of Medicine,Zagazig ,EGYPT. Introduction. Changes in the Skin Due to Pregnancy Skin Conditions Influenced by Pregnancy Pregnancy and Immune-Mediated Disorders Skin Conditions Specific to Pregnancy

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SKIN and PREGNANCY

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  1. SKINand PREGNANCY By Dr M. Y.Abd El-Mawla,MD Zagazig Faculty of Medicine,Zagazig ,EGYPT

  2. Introduction • Changes in the Skin Due to Pregnancy • Skin Conditions Influenced by Pregnancy • Pregnancy and Immune-Mediated Disorders • Skin Conditions Specific to Pregnancy • The Use of Drugs for Dermatologic

  3. Changes in the Skin Due to Pregnancy Hyperpigmentation Generalized or increase in pigment at specific areas such as the areolae, genitals, inner thighs, or axillae Melasma : In most cases, the hyperpigmentation : epidermal melanin deposition due to a combination of light exposure and elevated hormones (estrogen, progesterone, and melanocyte-stimulating hormone.

  4. Melasma

  5. Changes in the Skin Due to Pregnancy • Hair& Nail Changes • Hirsutism & frontoparietal thinning of male-pattern alopecia : increase in androgens • Postpartum: hirsutism resolves and hair may enter the telogen phase, resulting in the diffuse shedding of telogen effluvium • Nail changes : transverse grooving, brittleness, distal onycholysis, and subungual hyperkeratosis

  6. Telogen effluvium

  7. Androgenic aalopecia

  8. Erythema (most women) Spider telangiectases (66%) Vagina (Jacquemier-Chadwick sign)Cervix (Goodell's sign -- bluish)PalmsGingiva Chest Legs Face Vascular Changesin Pregnancy

  9. Varicosities (40% of women) Purpura Vasomotor instability Non pitting edema (50% of women Pyogenic granuloma Legs &Hemorrhoids Lower extremities Facial flushing ,Pallor Cutis marmorata ,Raynaud'sphenomena Face,lids &extremities Gingiva and othersites Vascular Changesin Pregnancy

  10. Pyogenic granuloma

  11. Glandular Changes • Increased Eccrineglands function: Miliaria ,Hyperhidrosis &Dyshidrotic eczema • Decreased Apocrine function: • Increased Sebaceous function in third trimester: Acne (variant-pruritic folliculitis of pregnancy) &Sebaceous glands on the areolae (Montgomery's glands)

  12. Connective Tissue Changes in Pregnancy • Striae distensae (90%) on the abdomen, on the breasts, thighs, and inguinal areas. • Mechanical stretch & increased hormones (adrenocortical, estrogen, and relaxin) are the most significant factors in the development of striae,

  13. Striae distensae

  14. Skin Conditions Influenced by Pregnancy • Melanomas :no increased risk of melanoma in pregnancy .When diagnosed during pregnancy may be thicker and therefore have a worse prognosis • Nevi: may develop, enlarge, or darken.& show mild cytologic atypia. • Dermatofibromas Leiomyomas Keloids Dermatofibrosarcoma: may develop or grow rapidly in pregnancy

  15. Other Skin Conditions Influenced by Pregnancy • Atopic dermatitis • More likely to worsen than improve • May present for the first time during pregnancy with keratosis pilaris • Irritant hand dermatitis due to washing postpartum &nipple dermatitis due to nursing

  16. Other Skin Conditions Influenced by Pregnancy Psoriasis: More likely to improve than worsen Psoriatic arthritis may worsen Impetigo herpetiformis (generalized pustular psoriasis) : during last trimester, but may present earlier &persists until delivery or long after Associated with decreased calcium and/or vitamin D Severe malaise, fever, nausea , vomiting, tetany, seizures Grouped pustules at the margins of symmetric erythematous patches

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