The specific dermatoses of pregnancy revisited and reclassified: results of a retrospective two-center study on 505 pregnant patients.
OBJECTIVE
We sought to evaluate the frequency and clinical characteristics of pruritic dermatoses in pregnancy and to assess a rationalized classification.


METHODS
Data of 505 pregnant patients seen at two university-based dermatologic hospitals (1994-2004) were retrospectively studied.


RESULTS
Diagnoses included eczema in pregnancy (49.7%), polymorphic eruption of pregnancy (PEP) (21.6%), pemphigoid gestationis (PG) (4.2%), intrahepatic cholestasis of pregnancy (ICP) (3%), prurigo of pregnancy (0.8%), pruritic folliculitis of pregnancy (0.2%), and miscellaneous dermatoses (20.6%). Eczema in pregnancy, prurigo of pregnancy, and pruritic folliculitis of pregnancy showed considerable overlap and were summarized as atopic eruption of pregnancy (AEP). While PEP, PG, and ICP presented in late pregnancy, AEP started significantly earlier. Primigravidae and multiple gestations were characteristic for PEP, abdominal involvement for PEP and PG, and a history of affected pregnancies for ICP.


CONCLUSIONS
This was a retrospective study.


CONCLUSIONS
We propose classifying the dermatoses of pregnancy as PG, PEP, AEP, and ICP. Stereotypic immunofluorescence and laboratory findings are diagnostic of PG and ICP, whereas distinct clinical characteristics facilitate discrimination between PEP and AEP.
Department of Dermatology, Medical University Graz, Graz, Austria. christina.ambros-rudolph@meduni-graz.at
Christina M
CM
Ambros-Rudolph
Robert R
RR
Müllegger
Samantha A
SA
Vaughan-Jones
Helmut
H
Kerl
Martin M
MM
Black
D000293:Adolescent; D000328:Adult; D000465:Algorithms; D005260:Female; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D011248:Pregnancy Complications / Q000145:classification* / Q000175:diagnosis* / Q000453:epidemiology; D011537:Pruritus / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology; D012189:Retrospective Studies; D012871:Skin Diseases / Q000145:classification* / Q000175:diagnosis* / Q000453:epidemiology