Inflammatory and Glandular Skin Disease in Pregnancy

• 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
• ISSN: 0738-081X; 1879-1131
• DOI: 10.1016/j.clindermatol.2016.02.005

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.