Assessment and management of itchy skin in pregnancy.

Abstract

Women with rashes or itchy skin during pregnancy will often present initially to the general practitioner. Knowledge of thespecific dermatoses of pregnancy willassist in diagnosis, management and,importantly, facilitation of timely escalation of care of conditions that canpotentially affect the fetus. The aim of this article is to provide a diagnostic framework for approaching apruritic rash during pregnancy as well asa helpful summary of management ofpregnancy-specific dermatoses. It will assist clinicians in the identification of specific dermatoses that pose fetal risks. In addition to considering non-pregnancy specific conditions when approaching pruritus or a pruritic rash in pregnancy, it is important that clinicians also consider pregnancy-specific dermatoses, which have been reclassified into four categories: polymorphic eruption of pregnancy, pemphigoid gestationis, intrahepatic cholestasis of pregnancy (ICP) and atopic eruption of pregnancy. Unlike the other dermatoses, ICP begins with pruritus, and skin changes are secondary. ICP and pemphigoid gestationis are associated with fetal riskssuch as prematurity and stillbirth.