Abstract
Psoriasis and hidradenitis suppurativa (HS) are chronic inflammatory skin diseases that frequently develop in young women. The aim of this study is to evaluate how hidradenitis suppurativa and psoriasis impact women desiring to conceive, and their influence on fertility and gestation. A systematic review of articles dating from January 2015 to April 2021 was performed using the Scopus (Elsevier) database. The search terms were (psoriasis and (birth or pregnancy or fertility)) and ((hidradenitis suppurativa or acne inversa) and (birth or pregnancy or fertility)). The search was limited to human data. Systematic reviews, case reports, clinical practice guidelines, expert consensus and conference papers were excluded. The impact of HS on pregnancy includes an impaired desire for pregnancy, a decrease in fertility, the worsening of the disease during pregnancy and potential adverse events during pregnancy. Moreover, the pregnancy might imply a change on the treatment of HS. The impact of psoriasis on pregnancy includes a decrease in fertility, potential adverse events during pregnancy and an unpredictable evolution of the disease. Moreover, the pregnancy might imply a change on the treatment of psoriasis, although biologic therapies do not appear to increase the risk of adverse events. In conclusion, both HS and psoriasis have an impact on pregnancy. A decrease of fertility has been reported. Moreover, both diseases have an unpredictable evolution during pregnancy. Pregnant women who are under biologic therapy do not seem to have a higher rate of adverse events. Treatment of both conditions is usually halted during pregnancy since scientific evidence about their safety is not conclusive, or teratogenic risk has been proven.
Highlights
Psoriasis is a chronic, immune-mediated skin disease characterized by the appearance of erythematous, scaly plaques on the scalp and extensor areas [1]
Materials and Methods A systematic review was performed to assess the impact of psoriasis and hidradenitis suppurativa (HS) on gestational desire, fertility and pregnancy
The results of this systematic review show that psoriasis and HS may lead to decreased fertility, may increase the number of adverse events during pregnancy and gestation may trigger a clinical worsening of the disease
Summary
Immune-mediated skin disease characterized by the appearance of erythematous, scaly plaques on the scalp and extensor areas [1]. Inflammation is not limited to the skin, favoring a systemic pro-inflammatory state that is associated with multiple comorbidities, such as overweight, hypertension, dyslipidemia and diabetes, which produce an increased cardiovascular risk and a higher risk of myocardial infarction and stroke [2]. Hidradenitis suppurativa (HS) is an immune-mediated skin disease characterized by the appearance of inflammatory nodules, abscesses and cysts, which generate fistulous tracts that release a purulent and malodorous liquid [6,7,8]. In HS there is a component of systemic inflammation that correlates with the severity of the disease and is associated, among others, with an increased cardiovascular risk [11]. The disease is more common in women and affects a considerable proportion of women of childbearing age [12]
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