Inflammatory and Glandular Skin Disease in Pregnancy

Abstract A switch from cell-mediated to humoral immunity (Th 1 to Th 2 shift) during gestation plays a key role in placental immune tolerance. As a result, skin diseases that are Th 2-mediated often worsen while skin diseases that are Th 1-mediated often improve during gestation. Also, due to fluctu...

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Bibliographic Details
Published in:Clinics in dermatology 2016-05, Vol.34 (3), p.335-343
Main Authors: Yang, Catherine S., MD, Teeple, Mary, MD, Muglia, Jennie, MD, Robinson-Bostom, Leslie, MD
Format: Article
Language:English
Subjects:
Acne Vulgaris - drug therapy
Acne Vulgaris - etiology
Dermatitis, Atopic - diagnosis
Dermatitis, Atopic - drug therapy
Dermatitis, Perioral - etiology
Dermatology
Erythema Nodosum - diagnosis
Female
Fox-Fordyce Disease - therapy
Hidradenitis Suppurativa - therapy
Humans
Pityriasis Rosea - diagnosis
Pityriasis Rosea - etiology
Pregnancy
Pregnancy Complications - diagnosis
Pregnancy Complications - etiology
Pregnancy Complications - therapy
Psoriasis - complications
Psoriasis - therapy
Remission, Spontaneous
Rosacea - therapy
Sarcoidosis - complications
Sarcoidosis - drug therapy
Skin Diseases - diagnosis
Skin Diseases - etiology
Skin Diseases - therapy
Sweet Syndrome - diagnosis
Symptom Flare Up
Urticaria - drug therapy
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Summary:Abstract A switch from cell-mediated to humoral immunity (Th 1 to Th 2 shift) during gestation plays a key role in placental immune tolerance. As a result, skin diseases that are Th 2-mediated often worsen while skin diseases that are Th 1-mediated often improve during gestation. Also, due to fluctuations in glandular activity, skin diseases involving sebaceous and eccrine glands may flare, while those involving apocrine glands may improve during pregnancy. Despite these trends, inflammatory and glandular skin diseases do not always follow the predicted pattern, and courses are often diverse. We review the gestational course of inflammatory skin diseases, such as atopic dermatitis (atopic eruption of pregnancy), psoriasis, impetigo herpetiformis, urticaria, erythema annulare centrifugum, pityriasis rosea, sarcoidosis, Sweet syndrome, and erythema nodosum, as well as glandular skin diseases, including acne vulgaris, acne rosacea, perioral dermatitis, hidradenitis suppurativa, Fox-Fordyce disease, hyperhidrosis, and miliaria. For each of the above diseases, we discuss the pathogenesis, clinical presentation, and management with special consideration for maternal and fetal safety.
ISSN:0738-081X
1879-1131
DOI:10.1016/j.clindermatol.2016.02.005