Atopic Eruption of Pregnancy
Atopic eruption of pregnancy is a term that encompasses other pruritic inflammatory dermatoses which appear or worsen during pregnancy:
- Atopic dermatitis in pregnancy
- Prurigo of pregnancy (Besnier) = intensely itchy papules
- Pruritic folliculitis of pregnancy = itchy inflammation around the hair follicle
pastules, bacterial
Diagnosis
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This is an example of an atopic eruption of pregnancy (prurigo type).
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Atopic eruption of pregnancy (AEP):
- Eczematous in 2/3 and prurigo type in 1/3
- Starts earlier in pregnancy (mean=18 weeks)
- 80% of patients have a previous history of atopic dermatitis while 20% do not
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AEP is a clinical diagnosis.
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Histopathology is non-specific.
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Immunofluorescence is negative.
AEP: Treatment
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AEP is a benign disease and does not carry increased maternal or fetal risks.
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Treatment is largely dependent on controlling the eruption with topical steroids.
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Oral steroids can be used in recalcitrant cases.
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If the eruption does not respond to topical steroids, referral to dermatology is recommended.
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The eruption may persist after pregnancy as a chronic dermatitis.
Case Four: History
- Sayda is a 25-year-old woman who comes in for an itchy eruption that began two weeks ago.
- She is 20 weeks pregnant with her second child. Her previous pregnancy was unremarkable.
- She is healthy and has no history of atopy.
![[Atopic Eruption of Pregnancy AEP-1747728771579.webp]]
Case Four, Question 1
- The best way to describe her lesions is: a. deep-seated nodules over the legs b. lichenified papules over the legs, some of which are excoriated c. multiple ill-defined scaly plaques d. well-demarcated, scaly macules scattered over the extremities
Case Four, Question 2
- Sayda is worried that her baby will be affected by her disease. What do you tell her? a. She will need to be monitored as a high-risk pregnancy. b. There have been reports of fetal distress in patients with AEP. c. There is a risk of small-for-gestational age births in AEP. d. There is no need to worry. Fetal distress is not increased in patients with AEP.