Management of rheumatic and autoimmune blistering disease in pregnancy and postpartum.
The treatment of rheumatic and autoimmune skin disease in women who are pregnant or of childbearing potential can present challenges to the dermatologist. We discuss the current approaches to treating lupus erythematosus, antiphospholipid antibody syndrome, dermatomyositis, morphea and systemic sclerosis, mixed connective tissue disease, rheumatoid arthritis, and autoimmune blistering disease in such patients. In the appropriate setting, topical and systemic corticosteroids, hydroxychloroquine, dapsone, azathioprine, and ultraviolet B phototherapy may be safely and cautiously used during pregnancy. Considerations about contraception, planned conception, therapeutic options, and disease control are paramount in optimizing pregnancy outcomes and minimizing risks to both mother and fetus.
Department of Dermatology, Perelman School of Medicine, Philadelphia, Pennsylvania.
Joy
J
Wan
Department of Internal Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Sotonye
S
Imadojemu
Department of Dermatology, Perelman School of Medicine, Philadelphia, Pennsylvania; Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania. Electronic address: Werth@mail.med.upenn.edu.
Victoria P
VP
Werth
D000818:Animals; D016736:Antiphospholipid Syndrome / Q000188:drug therapy; D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D000075202:Contraindications; D003879:Dermatologic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D003882:Dermatomyositis / Q000188:drug therapy; D005260:Female; D006801:Humans; D007774:Lactation; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy; D010392:Pemphigus / Q000628:therapy; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy* / Q000532:radiotherapy; D012594:Scleroderma, Localized / Q000628:therapy; D012595:Scleroderma, Systemic / Q000188:drug therapy; D012871:Skin Diseases / Q000188:drug therapy* / Q000532:radiotherapy; D014467:Ultraviolet Therapy
D003879:Dermatologic Agents