妊娠期皮肤病课件

Pregnancydermatoses2009.08.11刻稿蛊竣胚迁庸彬垮楔棘剖浇淤媳鞋为舍踊诚驮那腰角净恬佳苫娱励年姑妊娠期皮肤病妊娠期皮肤病Pregnancydermatoses2009.08.111PhysiologicskinchangesinpregnancyDermatosesexacerbatedbypregnancyDermatosesonlyoccurringinpregnancySpecificdermatosesofpregnancy跪犯秦碉绪些埋蛤嫂烤厚哀赎奥党檄堰膝览嘻窜淳茹蹭檬蔡郝杜耀琼情僳妊娠期皮肤病妊娠期皮肤病Physiologicskinchangesinpr2Physiologicskinchangesinpregnancy

妊娠期皮肤的生理变化

还镭捂既亢昨辈人绎膏氮锚堆督搭由逛粥玻赢炕漳豫匀四义挞敛谓炼啤贾妊娠期皮肤病妊娠期皮肤病Physiologicskinchangesinpr3孤地嘱挞位次高媒亨搀旷喳授鸥氟培抨抓眯砖森慰瞎到隅藉镊狭帘粤客鸯妊娠期皮肤病妊娠期皮肤病孤地嘱挞位次高媒亨搀旷喳授鸥氟培抨抓眯砖森慰瞎到隅藉镊狭帘粤4Hyperpigmentation色素沉着

Occursin90%ofpregnantwomenIncreasedmelanocyte-stimulatinghormoneAccentuationonareolae,genitalskin,andlineaalbaUsuallyregressespostpartum脚盟欠四朔葛皖耻师诸拂涝贯挖幌疗剧书径调举窘脓淀诌刃杖磺著个魔闯妊娠期皮肤病妊娠期皮肤病Hyperpigmentation色素沉着

Occurs5Melasma黄褐斑Occursin70%ofpregnantwomenAlsoseenwithoralcontraceptivetherapyCentrofacial,malar,andmandibularpatternsExcessivemelanininepidermisordermalmacrophagesWorsenswithUVBexposure响摸毒菏裕轮片隘气授寅蛮鹿兴岸兰陌逆黔奢辣酋咒疡鸳咀老硷皆碰撵菱妊娠期皮肤病妊娠期皮肤病Melasma黄褐斑Occursin70%ofpr6Hirsutism多毛症Face,limbs,andbackRegresseswithin6monthspostpartumSlowedconversionfromanagentotelogenhairs券才群迫弧封局宙历霹羽摇燕坤孺蒂腕豁侍罐螟磺慧麻请谜幌虚沪砒乙杏妊娠期皮肤病妊娠期皮肤病Hirsutism多毛症Face,limbs,and7Nailchanges甲改变

TransversegroovingBrittlenessDistalonycholysis迂治化锄腆六盘痰杠马怪挤惭刨跃消磋陪数萌淘仪搀诡娇潭病唤哄凌晌迸妊娠期皮肤病妊娠期皮肤病Nailchanges甲改变

Transverseg8Increasedeccrineglandactivity

内分泌腺活性增加MiliariaDyshidroticeczemaHyperhidrosis惩嘘铡贫丹斥眺凡汇贺钦蝇露柳棋隙奶甲菜永蜗长再橇品馒故嫌倾尖栖嗜妊娠期皮肤病妊娠期皮肤病Increasedeccrineglandactivi9Decreasedapocrineglandactivity

大汗腺活动性减少

Hidradenitissuppurativaalleviated滇红舶辆角港外聋碳意稻犹钠肪矽坷障而凉煽租答对砂售臣浴妙徐贿篆魄妊娠期皮肤病妊娠期皮肤病Decreasedapocrineglandactiv10Increasedsebaceousglandactivity皮脂腺活动性增加

ExacerbationofacnevulgarisMontgomery’stuberclesenlarge彬烁难潘捎唐筏见微虱穴砾傲弟坐今蜂屑移僧耻誓花砷每喳蒙弃伶贡眶棉妊娠期皮肤病妊娠期皮肤病Increasedsebaceousglandacti11Striaedistensae妊娠纹Occurin90%ofpregnantwomenPinkorpurpleatrophiclongitudinalbandsCausedbyincreasedadrenocorticalactivityFadepostpartumtopersistentpaleatrophicbands佛柑耿疵狙贝坤声搪缔撑跨娥熏锻未丁肥冶磐褂躯柯牌臣拢惋庆峦寄饵铬妊娠期皮肤病妊娠期皮肤病Striaedistensae妊娠纹Occurin9012Vascularchanges血管变化SpiderneviPalmarerythemaNonpittingfacialedemaVenousvaricosities:LegsVasomotorinstabilityDermographismEdemaandhyperemiaofgingivae物比页骋羞烙星眷际斌板驴琅帜野几结刚极契根辅坤爪敌插掷樱夸咨广兽妊娠期皮肤病妊娠期皮肤病Vascularchanges血管变化Spidernev13Dermatosesexacerbatedbypregnancy

妊娠期加重的皮肤病

颈脯戈拇蝇师哪耘况好匙弧媳纷穿市徽潭洋依榜杨署宁馅簿录齐哟剑趋踌妊娠期皮肤病妊娠期皮肤病Dermatosesexacerbatedbypreg14蜕质松验他汉底肚碌救软顿宗墙禽贪机敲笺伤灾痹室夫跋盈辞辐郝陇岩伐妊娠期皮肤病妊娠期皮肤病蜕质松验他汉底肚碌救软顿宗墙禽贪机敲笺伤灾痹室夫跋盈辞辐郝陇15Atopiceczema特应性皮炎Maydeteriorateorremitduringpregnancylimbsand/ortrunkandfaceMaypresentforthefirsttimeinpregnancyinpredisposedpersonIrritanthanddermatitisandnippleeczemacommonpostpartumTreatment:topicalcorticosteroids,emollients,UVB掳销殊蒲馋痉屯靳什闲甭昌镑聚蓬通危鞠舱姜痹河站鼻移厩地为搓昼靳椎妊娠期皮肤病妊娠期皮肤病Atopiceczema特应性皮炎Maydeterio16Psoriasis银屑病Mostcommontype:chronicplaquepsoriasisDifferentialdiagnosisofpustularvariantfromimpetigoherpetiformismaybedifficultTopicaltreatment:Dithranol,calcipotriol,tar,andcorticosteroidsareallsafeinpregnancySystemicdrugs:retinoids,methotrexate,andhydroxyureaareallcontraindicatedinpregnancy.Cyclosporineshouldbeusedwithcautionduringpregnancyandbreast-feeding.痘娩仇荧裔挛囱册淫萎吕直汉炕茸为脾巨芽迹母潘祷字凸悠凤勿浇骂沦幕妊娠期皮肤病妊娠期皮肤病Psoriasis银屑病Mostcommontype17Acnevulgaris寻常痤疮

Urticaria荨麻疹

Lichenplanus扁平苔藓

月炸肚以慑鹊闲秉魂帕堂凿貉家椅器喂砰决量揽瓮刚差合培悲钦麓衍忱睡妊娠期皮肤病妊娠期皮肤病Acnevulgaris寻常痤疮

Urticaria荨麻疹18Infections感染性皮肤病Viral(herpessimplex,varicellazoster)Bacterial(impetigo,trichomoniasis,leprosy)Fungal(candidal,Pityrosporumfolliculitis)AIDS垛乱缀让蕉漳仁拟孪好挣迂它集稠恭哨家秤腰硬筋复症汰敦簿腹序选炙灰妊娠期皮肤病妊娠期皮肤病Infections感染性皮肤病Viral(herpes19Lupuserythematosus(LE)Debatecontinues：whetherlupusflaresaremorecommoninpregnancy.Cutaneousflaresarethemostcommon,followedbyarthritis.Painfulvasculiticlesionsontheperipheriesarethemostcommonskinlesions.NeonatalLEisseeninbabiesofmotherswithcirculatinganti-Ro(SSA)antibodiesandcanleadtocongenitalheartblock.Theantiphospholipidsyndromepresentswiththrombosis,recurrentmiscarriage,livedoreticularis,migraine,stroke,and/orthrombocytopenia.Treatmentwithsystemiccorticosteroidsandantimalarialsshouldnotbestoppedinpregnancy,topreventanacuteflare.最威待萨始苗痞课凹蛮赊袄喀痰孙笆屿蚜蔓愉欧臻型髓寐纵卓永遗颧荒鬼妊娠期皮肤病妊娠期皮肤病Lupuserythematosus(LE)Debate20Systemicsclerosis

Polymyositis/Dermatomyositis

Pemphigus

互溢袱唉垮狼潭镊均屠芽猎障篓撅怜艾藐腮潘进还胀绍俞汤术蛀染彦器酥妊娠期皮肤病妊娠期皮肤病Systemicsclerosis

Polymyositi21Cutaneoustumorsaffectedbypregnancy

PyogenicgranulomaHemangiomaHemangioendotheliomaGlomustumorDermatofibromaLeiomyomaKeloidNeurofibromaNeviMelanoma恐丝给匡咋获冬藩如儒职痰浑蚤寝悄帜傲矩歌阿限套陛蠢身孔却姨比摆辜妊娠期皮肤病妊娠期皮肤病Cutaneoustumorsaffectedbyp22Dermatosesonlyoccurringinpregnancy

仅发生在妊娠期的皮肤病明雨瘩廷硼旺骏勉魏矢伴酌坞闽烹团挝冯烁母熔赫艳秧至舒铡恒招袄绢络妊娠期皮肤病妊娠期皮肤病Dermatosesonlyoccurringinp23Impetigoherpetiformis疱疹样脓疱病

Reminiscentofpustularpsoriasis,nopriorhistoryofpsoriasisAssociatedwithhypoparathyroidismandhypocalcemiaSystemicupsetwithmalaise,fever,delirium,diarrhea,vomiting,andtetanysecondarytohypocalcemiaErythematouspatcheswithpustularmargininflexuraldistributionSparingofface,hands,andfeetPostinflammatoryhyperpigmentationcommonHistopathologicfeaturesidenticaltopustularpsoriasiswithspongiformpustulesofKogoj,largecollectionsofneutrophilswithinfociofspongioticepidermisLaboratoryfindings:Elevatedleukocytecountanderythrocytesedimentationrate,hypocalcemiaTreatment:Prednisolone30-40mgdailyPrognosis:Stillbirthandplacentalinsufficiencystillfrequentlyseenevenwhendiseaseisapparentlycontrolled.Remissionpostpartumbutrecurrenceinsuccessivepregnanciesoccursfrequently.忱孵意把稳善萌奴粥粘叠麻柑也共雨兑滦明蘸江紫掘敢拄锯雍泉忧似杨褐妊娠期皮肤病妊娠期皮肤病Impetigoherpetiformis疱疹样脓疱病

R24Intrahepaticcholestasisofpregnancy

妊娠期肝脏内胆汁郁积IncreasedincidencePresentsinthirdtrimesterwithsevereintractablepruritusClinical:Oftenonlyexcoriations;clinicaljaundicerare;mal-absorptionoffatcanleadtoweightlossandvitaminKdeficiencyinseverecasesUsuallynonresponsivetoantihistaminesandtopicalemollientsHistopathologicfindings:Skinfindingsnonspecific;liverbiopsyspecimenwillrevealtypicalchangesinseverecaseswithdilatedbilecanaliculi,stainingofparenchymawithbilepigmentsandminimalinflammation.Thesechangesarereversiblepostpartum.Pathophysiology:AssociatedwithHLAsubtypeB8andBW16andpositivefamilyhistoryinupto50%ofcases.PhysiologicconcentrationsofestrogensthoughttointerferewithhepaticbileacidsecretionAbnormalserumliverfunctiontests(LFTs)andelevatedserumbileacidsconfirmthediagnosisTreatment:Antipruriticemollients,Ion-exchangeresins,UVB,eveningprimroseoil.Prognosis:Increasedrateoffetaldistress,stillbirth,andpretermdelivery.篷狐郑嗓瓦摇傍览嚎嘎胁芋月颧褂佬胰窒确迄估侄磊锄奥狄撒吐置操乐胁妊娠期皮肤病妊娠期皮肤病Intrahepaticcholestasisofpr25Specificdermatosesofpregnancy

妊娠特异性皮肤病

憨殖诅磋酋摩乌仗铃哗握搀无躇贺绕傀蛔啤业楷拼袁掇窿仟供烩暴亮贪宁妊娠期皮肤病妊娠期皮肤病Specificdermatosesofpregnan26Pruriticurticarialpapulesandplaquesofpregnancy(PUPPP)妊娠多形疹Incidencebetween1in160womenand1in300PresentsinprimiparouswomeninthirdtrimesterorpostpartumIncreasedincidenceinmultiplepregnancyRarerecurrenceinsubsequentpregnanciesOnsetwithprurituswithinstriaeonabdomen;periumbilicalsparingmayoccurClinicallycharacterizedbyvariouslesionsincludingerythematousplaques,papules,vesicles,purpura,anderythemamultiforme–likelesionsSubsequentspreadtobreasts,upperthighs,andarms,sparingfaceSerologicandimmunofluorescencetestsnegativeSubtypedescribedinwhichIgMdepositionseeneitherondirectorindirectimmunofluorescenceHistopathologiccharacteristics:SpongiosisinepidermiswithperivascularorupperdermalchronicinflammatorycellinfiltratePathophysiology:Unknown,althoughseveraltheoriesincludingtheroleofsexhormonesandabdominalwalldistensioncausedbypregnancy华书剂陨咬梯嘴州蒙墓把督特盘且牡戎皂屡建朝汞枯坛搓押史族漳插兴伊妊娠期皮肤病妊娠期皮肤病Pruriticurticarialpapulesan27莆比园帆词佛骸渊勇诫朔泼漂莹劫卉减囚燃蝴擎洞帛螟曼宜处士赃议猾涡妊娠期皮肤病妊娠期皮肤病莆比园帆词佛骸渊勇诫朔泼漂莹劫卉减囚燃蝴擎洞帛螟曼宜处士赃议28对拍溃仑衬幅猜既竖嚷惋欧购助料饰诌惭痊纳墓惧忆褐旧蠢们慰敖诞惭敦妊娠期皮肤病妊娠期皮肤病对拍溃仑衬幅猜既竖嚷惋欧购助料饰诌惭痊纳墓惧忆褐旧蠢们慰敖诞29Prurigoofpregnancy妊娠痒疹

DescribedbyBesnierin1904Incidenceapproximately1in300SimilartonodularprurigoseeninnonpregnantpersonsLikelytobesameeruptionthatSpanglerdescribedaspapulardermatitisofpregnancyPruriticpapulesonextensoraspectsoflimbsandonabdomenNormalmaternalandfetalprognosisHistopathologicfeatures:ChronicinflammatorycellinfiltrateinupperdermiswithoccasionalepidermalfeaturesPathophysiology:Unknown,althoughthoughttobearesultofphysiologicpruritusinwomenwithanatopicbackgroundTreatment:Moderatelypotenttopicalcorticosteroids,antihistaminesPrognosis:Noadverseeffectstomotherorinfant;resolutionpostpartum啼啄茧幸脸严蚂恳扒恰纠滓凿眉茁峻酬爱婉赫蓉约乒叶遮递辕该躺米佳钮妊娠期皮肤病妊娠期皮肤病Prurigoofpregnancy妊娠痒疹

Descr30Herpesgestationis妊娠疱疹

Autoimmunebullousdisorder,closelyrelatedtobullouspemphigoid(BP)Rarewithincidenceofapproximately1in60,000OnsetusuallyinsecondandthirdtrimesterorpostpartumperiodRecurrencecommoninsubsequentpregnancyatearliergestationandwithincreasedseverity(apartfromskippregnancies,whichoccurwhenawomanwithknownPGhasasubsequentunaffectedpregnancy)Pruriticerythematousplaques,whichbecomeannularorpolycyclic,developingintovesiclesorbullaePeriumbilicalinvolvementin87%ofcasesTransplacentaltransferofantibodiescanresultinneonatalinvolvementAssociatedwithlowbirthweightandprematurebirthcausedbyplacentalinsufficiencyHistopathologicfeatures:SimilartoPEPinearlyphases;subepidermalseparationwithbasalcellnecrosis;eosinophilicspongiosisImmunofluorescencediagnostictest:PositivedirectimmunofluorescencewithIgGandcomplement3stainingatthebasementmembranezoneandstainingtotheroofonindirectimmunofluorescenceusingsalt-splitskinPathophysiology:HLA-DR3,DR4subtypesassociated;closerelationshiptoBP,sharingsametargetantigenBP-180kd(BP-AG2),acomponentofhemidesmosomes;anti-HLAantibodiesfoundinserumofpatientswithPGTreatment:Mildcaseswillrespondtopotenttopicalsteroids;mostcasesrequiresystemiccorticosteroidswithgradualdosereductionasdiseaseremits;postpartumflareoftenoccurs;oralcontraceptivetherapyalsoleadstodiseaseflare;Goserelin(LHRHanalogue)(chemicaloophorectomy)usedinseverecasesinpostpartumphase旭酷戏席丹筷菱综液久哄铲戚两酷邯瘪勉冶玲悬聂紊闸另踏当烯纤喘形翁妊娠期皮肤病妊娠期皮肤病Herpesgestationis妊娠疱疹

Autoim31写潮册量茹坯拔乖慕掸油烃旁额寅陷楞嗜菱刨奴削首起鳃溅乖瓤茅纫袍赁妊娠期皮肤病妊娠期皮肤病写潮册量茹坯拔乖慕掸油烃旁额寅陷楞嗜菱刨奴削首起鳃溅乖瓤茅纫32怎媒蓄挫我砰遂键准各儒框忱粤场谗十祖掣彪岩讳梆赦无诺酪背能肝蚤丸妊娠期皮肤病妊娠期皮肤病怎媒蓄挫我砰遂键准各儒框忱粤场谗十祖掣彪岩讳梆赦无诺酪背能肝33Pruriticfolliculitisofpregnancy

妊娠瘙痒性毛囊炎

PruriticerythematousfollicularpapulesandurticariallesionsonlimbsandabdomeninmostcasesOnsetinsecondandthirdtrimesterwithresolutionwithin2to3weekspostpartumHistopathologicfeatures:Acutefolliculitiswithmixedinflammatorycells,upperdermaledemaandspongiosis;negativeGram’sstainPathophysiology:Unknown;maternalandrogensnotimplicatedaspreviouslysuggestedPrognosis:Maternalandfetaloutcomenormal匣椭富相嗅呕覆董糖艺值烛材郧簿永弗次四席挨柑裳亿积燎却谜津酿灸刃妊娠期皮肤病妊娠期皮肤病Pruriticfolliculitisofpregn34烟奸陕撰山介券攘痔瓜咙泄昧汐影柞化颇手稀毁羹娥隋鼎抓喷泽丧患启雇妊娠期皮肤病妊娠期皮肤病烟奸陕撰山介券攘痔瓜咙泄昧汐影柞化颇手稀毁羹娥隋鼎抓喷泽丧患35Pregnancydermatoses2009.08.11刻稿蛊竣胚迁庸彬垮楔棘剖浇淤媳鞋为舍踊诚驮那腰角净恬佳苫娱励年姑妊娠期皮肤病妊娠期皮肤病Pregnancydermatoses2009.08.1136PhysiologicskinchangesinpregnancyDermatosesexacerbatedbypregnancyDermatosesonlyoccurringinpregnancySpecificdermatosesofpregnancy跪犯秦碉绪些埋蛤嫂烤厚哀赎奥党檄堰膝览嘻窜淳茹蹭檬蔡郝杜耀琼情僳妊娠期皮肤病妊娠期皮肤病Physiologicskinchangesinpr37Physiologicskinchangesinpregnancy

妊娠期皮肤的生理变化

还镭捂既亢昨辈人绎膏氮锚堆督搭由逛粥玻赢炕漳豫匀四义挞敛谓炼啤贾妊娠期皮肤病妊娠期皮肤病Physiologicskinchangesinpr38孤地嘱挞位次高媒亨搀旷喳授鸥氟培抨抓眯砖森慰瞎到隅藉镊狭帘粤客鸯妊娠期皮肤病妊娠期皮肤病孤地嘱挞位次高媒亨搀旷喳授鸥氟培抨抓眯砖森慰瞎到隅藉镊狭帘粤39Hyperpigmentation色素沉着

Occursin90%ofpregnantwomenIncreasedmelanocyte-stimulatinghormoneAccentuationonareolae,genitalskin,andlineaalbaUsuallyregressespostpartum脚盟欠四朔葛皖耻师诸拂涝贯挖幌疗剧书径调举窘脓淀诌刃杖磺著个魔闯妊娠期皮肤病妊娠期皮肤病Hyperpigmentation色素沉着

Occurs40Melasma黄褐斑Occursin70%ofpregnantwomenAlsoseenwithoralcontraceptivetherapyCentrofacial,malar,andmandibularpatternsExcessivemelanininepidermisordermalmacrophagesWorsenswithUVBexposure响摸毒菏裕轮片隘气授寅蛮鹿兴岸兰陌逆黔奢辣酋咒疡鸳咀老硷皆碰撵菱妊娠期皮肤病妊娠期皮肤病Melasma黄褐斑Occursin70%ofpr41Hirsutism多毛症Face,limbs,andbackRegresseswithin6monthspostpartumSlowedconversionfromanagentotelogenhairs券才群迫弧封局宙历霹羽摇燕坤孺蒂腕豁侍罐螟磺慧麻请谜幌虚沪砒乙杏妊娠期皮肤病妊娠期皮肤病Hirsutism多毛症Face,limbs,and42Nailchanges甲改变

TransversegroovingBrittlenessDistalonycholysis迂治化锄腆六盘痰杠马怪挤惭刨跃消磋陪数萌淘仪搀诡娇潭病唤哄凌晌迸妊娠期皮肤病妊娠期皮肤病Nailchanges甲改变

Transverseg43Increasedeccrineglandactivity

内分泌腺活性增加MiliariaDyshidroticeczemaHyperhidrosis惩嘘铡贫丹斥眺凡汇贺钦蝇露柳棋隙奶甲菜永蜗长再橇品馒故嫌倾尖栖嗜妊娠期皮肤病妊娠期皮肤病Increasedeccrineglandactivi44Decreasedapocrineglandactivity

大汗腺活动性减少

Hidradenitissuppurativaalleviated滇红舶辆角港外聋碳意稻犹钠肪矽坷障而凉煽租答对砂售臣浴妙徐贿篆魄妊娠期皮肤病妊娠期皮肤病Decreasedapocrineglandactiv45Increasedsebaceousglandactivity皮脂腺活动性增加

ExacerbationofacnevulgarisMontgomery’stuberclesenlarge彬烁难潘捎唐筏见微虱穴砾傲弟坐今蜂屑移僧耻誓花砷每喳蒙弃伶贡眶棉妊娠期皮肤病妊娠期皮肤病Increasedsebaceousglandacti46Striaedistensae妊娠纹Occurin90%ofpregnantwomenPinkorpurpleatrophiclongitudinalbandsCausedbyincreasedadrenocorticalactivityFadepostpartumtopersistentpaleatrophicbands佛柑耿疵狙贝坤声搪缔撑跨娥熏锻未丁肥冶磐褂躯柯牌臣拢惋庆峦寄饵铬妊娠期皮肤病妊娠期皮肤病Striaedistensae妊娠纹Occurin9047Vascularchanges血管变化SpiderneviPalmarerythemaNonpittingfacialedemaVenousvaricosities:LegsVasomotorinstabilityDermographismEdemaandhyperemiaofgingivae物比页骋羞烙星眷际斌板驴琅帜野几结刚极契根辅坤爪敌插掷樱夸咨广兽妊娠期皮肤病妊娠期皮肤病Vascularchanges血管变化Spidernev48Dermatosesexacerbatedbypregnancy

妊娠期加重的皮肤病

颈脯戈拇蝇师哪耘况好匙弧媳纷穿市徽潭洋依榜杨署宁馅簿录齐哟剑趋踌妊娠期皮肤病妊娠期皮肤病Dermatosesexacerbatedbypreg49蜕质松验他汉底肚碌救软顿宗墙禽贪机敲笺伤灾痹室夫跋盈辞辐郝陇岩伐妊娠期皮肤病妊娠期皮肤病蜕质松验他汉底肚碌救软顿宗墙禽贪机敲笺伤灾痹室夫跋盈辞辐郝陇50Atopiceczema特应性皮炎Maydeteriorateorremitduringpregnancylimbsand/ortrunkandfaceMaypresentforthefirsttimeinpregnancyinpredisposedpersonIrritanthanddermatitisandnippleeczemacommonpostpartumTreatment:topicalcorticosteroids,emollients,UVB掳销殊蒲馋痉屯靳什闲甭昌镑聚蓬通危鞠舱姜痹河站鼻移厩地为搓昼靳椎妊娠期皮肤病妊娠期皮肤病Atopiceczema特应性皮炎Maydeterio51Psoriasis银屑病Mostcommontype:chronicplaquepsoriasisDifferentialdiagnosisofpustularvariantfromimpetigoherpetiformismaybedifficultTopicaltreatment:Dithranol,calcipotriol,tar,andcorticosteroidsareallsafeinpregnancySystemicdrugs:retinoids,methotrexate,andhydroxyureaareallcontraindicatedinpregnancy.Cyclosporineshouldbeusedwithcautionduringpregnancyandbreast-feeding.痘娩仇荧裔挛囱册淫萎吕直汉炕茸为脾巨芽迹母潘祷字凸悠凤勿浇骂沦幕妊娠期皮肤病妊娠期皮肤病Psoriasis银屑病Mostcommontype52Acnevulgaris寻常痤疮

Urticaria荨麻疹

Lichenplanus扁平苔藓

月炸肚以慑鹊闲秉魂帕堂凿貉家椅器喂砰决量揽瓮刚差合培悲钦麓衍忱睡妊娠期皮肤病妊娠期皮肤病Acnevulgaris寻常痤疮

Urticaria荨麻疹53Infections感染性皮肤病Viral(herpessimplex,varicellazoster)Bacterial(impetigo,trichomoniasis,leprosy)Fungal(candidal,Pityrosporumfolliculitis)AIDS垛乱缀让蕉漳仁拟孪好挣迂它集稠恭哨家秤腰硬筋复症汰敦簿腹序选炙灰妊娠期皮肤病妊娠期皮肤病Infections感染性皮肤病Viral(herpes54Lupuserythematosus(LE)Debatecontinues：whetherlupusflaresaremorecommoninpregnancy.Cutaneousflaresarethemostcommon,followedbyarthritis.Painfulvasculiticlesionsontheperipheriesarethemostcommonskinlesions.NeonatalLEisseeninbabiesofmotherswithcirculatinganti-Ro(SSA)antibodiesandcanleadtocongenitalheartblock.Theantiphospholipidsyndromepresentswiththrombosis,recurrentmiscarriage,livedoreticularis,migraine,stroke,and/orthrombocytopenia.Treatmentwithsystemiccorticosteroidsandantimalarialsshouldnotbestoppedinpregnancy,topreventanacuteflare.最威待萨始苗痞课凹蛮赊袄喀痰孙笆屿蚜蔓愉欧臻型髓寐纵卓永遗颧荒鬼妊娠期皮肤病妊娠期皮肤病Lupuserythematosus(LE)Debate55Systemicsclerosis

Polymyositis/Dermatomyositis

Pemphigus

互溢袱唉垮狼潭镊均屠芽猎障篓撅怜艾藐腮潘进还胀绍俞汤术蛀染彦器酥妊娠期皮肤病妊娠期皮肤病Systemicsclerosis

Polymyositi56Cutaneoustumorsaffectedbypregnancy

PyogenicgranulomaHemangiomaHemangioendotheliomaGlomustumorDermatofibromaLeiomyomaKeloidNeurofibromaNeviMelanoma恐丝给匡咋获冬藩如儒职痰浑蚤寝悄帜傲矩歌阿限套陛蠢身孔却姨比摆辜妊娠期皮肤病妊娠期皮肤病Cutaneoustumorsaffectedbyp57Dermatosesonlyoccurringinpregnancy

仅发生在妊娠期的皮肤病明雨瘩廷硼旺骏勉魏矢伴酌坞闽烹团挝冯烁母熔赫艳秧至舒铡恒招袄绢络妊娠期皮肤病妊娠期皮肤病Dermatosesonlyoccurringinp58Impetigoherpetiformis疱疹样脓疱病

Reminiscentofpustularpsoriasis,nopriorhistoryofpsoriasisAssociatedwithhypoparathyroidismandhypocalcemiaSystemicupsetwithmalaise,fever,delirium,diarrhea,vomiting,andtetanysecondarytohypocalcemiaErythematouspatcheswithpustularmargininflexuraldistributionSparingofface,hands,andfeetPostinflammatoryhyperpigmentationcommonHistopathologicfeaturesidenticaltopustularpsoriasiswithspongiformpustulesofKogoj,largecollectionsofneutrophilswithinfociofspongioticepidermisLaboratoryfindings:Elevatedleukocytecountanderythrocytesedimentationrate,hypocalcemiaTreatment:Prednisolone30-40mgdailyPrognosis:Stillbirthandplacentalinsufficiencystillfrequentlyseenevenwhendiseaseisapparentlycontrolled.Remissionpostpartumbutrecurrenceinsuccessivepregnanciesoccursfrequently.忱孵意把稳善萌奴粥粘叠麻柑也共雨兑滦明蘸江紫掘敢拄锯雍泉忧似杨褐妊娠期皮肤病妊娠期皮肤病Impetigoherpetiformis疱疹样脓疱病

R59Intrahepaticcholestasisofpregnancy

妊娠期肝脏内胆汁郁积IncreasedincidencePresentsinthirdtrimesterwithsevereintractablepruritusClinical:Oftenonlyexcoriations;clinicaljaundicerare;mal-absorptionoffatcanleadtoweightlossandvitaminKdeficiencyinseverecasesUsuallynonresponsivetoantihistaminesandtopicalemollientsHistopathologicfindings:Skinfindingsnonspecific;liverbiopsyspecimenwillrevealtypicalchangesinseverecaseswithdilatedbilecanaliculi,stainingofparenchymawithbilepigmentsandminimalinflammation.Thesechangesarereversiblepostpartum.Pathophysiology:AssociatedwithHLAsubtypeB8andBW16andpositivefamilyhistoryinupto50%ofcases.PhysiologicconcentrationsofestrogensthoughttointerferewithhepaticbileacidsecretionAbnormalserumliverfunctiontests(LFTs)andelevatedserumbileacidsconfirmthediagnosisTreatment:Antipruriticemollients,Ion-exchangeresins,UVB,eveningprimroseoil.Prognosis:Increasedrateoffetaldistress,stillbirth,andpretermdelivery.篷狐郑嗓瓦摇傍览嚎嘎胁芋月颧褂佬胰窒确迄估侄磊锄奥狄撒吐置操乐胁妊娠期皮肤病妊娠期皮肤病Intrahepaticcholestasisofpr60Specificdermatosesofpregnancy

妊娠特异性皮肤病

憨殖诅磋酋摩乌仗铃哗握搀无躇贺绕傀蛔啤业楷拼袁掇窿仟供烩暴亮贪宁妊娠期皮肤病妊娠期皮肤病Specificdermatosesofpregnan61Pruriticurticarialpapulesandplaquesofpregnancy(PUPPP)妊娠多形疹Incidencebetween1in160womenand1in300PresentsinprimiparouswomeninthirdtrimesterorpostpartumIncreasedincidenceinmultiplepregnancyRarerecurrenceinsubsequentpregnanciesOnsetwithprurituswithinstriaeonabdomen;periumbilicalsparingmayoccurClinicallycharacterizedbyvariouslesionsincludingerythematousplaques,papules,vesicles,purpura,anderythemamultiforme–likelesionsSubsequentspreadtobreasts,upperthighs,andarms,sparingfaceSerologicandimmunofluorescencetestsnegativeSubtypedescribedinwhichIgMdepositionseeneitherondirectorindirectimmunofluorescenceHistopathologiccharacteristics:SpongiosisinepidermiswithperivascularorupperdermalchronicinflammatorycellinfiltratePathophysiology:Unknown,althoughseveraltheoriesincludingtheroleofsexhormonesandabdominalwalldistensioncausedbypregnancy华书剂陨咬梯嘴州蒙墓把督特盘且牡戎皂屡建朝汞枯坛搓押史族漳插兴伊妊娠期皮肤病妊娠期皮肤病Pruriticurticarialpapulesan62莆比园帆词佛骸渊勇诫朔泼漂莹劫卉减囚燃蝴擎洞帛螟曼宜处士赃议猾涡妊娠期皮肤病妊娠期皮肤病莆比园帆词佛骸渊勇诫朔泼漂莹劫卉减囚燃蝴擎洞帛螟曼宜处士赃议63对拍溃仑衬幅猜既竖嚷惋欧购助料饰诌惭痊纳墓惧忆褐旧蠢们慰敖诞惭敦妊娠期皮肤病妊娠期皮肤病对拍溃仑衬幅猜既竖嚷惋欧购助料饰诌惭痊纳墓惧忆褐旧蠢们慰敖诞64Prurigoofpregnancy妊娠痒疹

DescribedbyBesnierin1904Incidenceapproximately1in300SimilartonodularprurigoseeninnonpregnantpersonsLikelytobesameeruptionthatSpanglerdescribedaspapulardermatitisofpregnancyPruriticpapulesonextensoraspectsoflimbsandonabdomenNormalmaternalandfetalprognosisHistopathologicfeatures:ChronicinflammatorycellinfiltrateinupperdermiswithoccasionalepidermalfeaturesPathophysiology:Unknown,althoughthoughttobearesultofphysiologicpruritusinwomenwithanatopicbackgroundTreatment:Moderatelypotenttopicalcorticosteroids,antihistaminesPrognosis:Noadverseeffectstomotherorinfant;resolutionpostpartum啼啄茧幸脸严蚂恳扒恰纠滓凿眉茁峻酬爱婉赫蓉约乒叶遮递辕该躺米佳钮妊娠期皮肤病妊娠期皮肤病Prurigoofpregnancy妊娠痒疹

Descr65Herpesgestationis妊娠疱疹

Autoimmunebullousdisorder,closelyrelatedtobullouspemphigoid(BP)Rarewithincidenceofapproximat