Atopic Eruption Of Pregnancy Research Articles

Skin Care in Pregnancy and the Postnatal Period

A great deal of advice around maintaining health is focused on nutrition and exercise – in particular what to do and what not to do. Little focus is on the importance of skin care. Just like the heart and lungs, the skin is an organ of the body. In fact it is the largest of all of the organs. It has many functions, many of which support us to maintain health and wellbeing through a complex eco system of the microbiome where it provides protections against pathogens, supports vitamin synthesis, metabolism and immune development.1 In pregnancy, the body’s organs undergo a myriad of physiological changes affecting each system differently.2 There are three categories of skin conditions in pregnancy, benign hormone-related changes such as hyperpigmentation and striae gravidarum, pre-existing skin conditions, such as acne and psoriasis, and pregnancy-specific disorders such as atopic eruption of pregnancy.3 Each will require different treatment or care to minimise discomfort or irritation.

Prevalensi Kelainan Kulit pada Masa Kehamilan

Hormonal, vascular, immunological and metabolic changes in pregnancy can cause many changes in body systems. This condition has an impact on skin changes associated specifically with pregnancy (dermatoses in pregnancy). These changes can be physiological or pathological. This condition is usually considered normal and ignored by health workers but can affect the quality of life in pregnant women. This study was conducted to determine the prevalence of both physiological and pathological skin changes in pregnancy. In this systematic review, literature was reviewed through three databases in accordance with the 2020 PRISMA guidelines. Inclusion criteria were primary literature or journals, full text, in English or Indonesian, published in 2013-2023, examined the prevalence of skin disorders in pregnancy, cross-sectional study design sectionals, cohorts. The study that cannot be accessed in full text and in the form of a review is excluded from the literature review. Most skin disorder changes in pregnant women are in the form of physiological disorders with the type of hyperpigmentation. While the most pathological changes are Atopic Eruption of Pregnancy (AEP) and Polymorphic Eruption of Pregnancy (PEP).

Clinical Patterns and Frequency of Dermatological Manifestations Associated with Pregnancy

Introduction: Pregnancy is a physiological state of women which is associated with intricate endocrinological, immunological, metabolic & vascular changes. So pregnancy makes a woman susceptible to various changes in skin & appendages. Alteration to the immune state of the pregnant women is necessary to allow mother to tolerate genetically different tissue during pregnancy. Decrease in cell mediated immunity in normal pregnancy is mainly responsible for the higher frequency and severity of certain infectious diseases. Some of which can also be transmitted to the baby during child birth. Moreover there are marked changes in the levels of sex hormones particularly oestrogen & progesterone and this can lead to profound changes in skin. Objective: To find the prevalence of dermatological manifestations in pregnant patients presenting in a tertiary care hospital Study Design: Descriptive/Cross-sectional Study Setting: The study was done in the Dermatology unit DHQ Hospital Faisalabad. Duration of Study: The study was carried out from 1st October 2016 to 10th March 2017 Subjects and methods: 185 pregnant women presenting at any gestational age in dermatology department and patients referred from Gynae department with dermatological complaints were included in the study. Patients with pre-existing medical conditions such as hypertension and diabetes were excluded. Complete history and clinical features of the patients were accessed and relevant investigations were done to support the diagnosis. Final diagnosis was made on basis of history, clinical examination and laboratory confirmation of disease as per operational definition. LFT’s for intrahepatic cholestasis of pregnancy was done from DHQ laboratory and sample for skin biopsy for pemphigoid gestationis were sent to pathology laboratory FMU. All the data was recorded in a well-structured questionnaire. Results: Age range in this study was from 18 to 40 years with mean age of 30.129±3.26 years and mean duration of disease was 5.864±1.79 week. Majority of the women were with 2nd trimester of pregnancy (67%). 60% of women had no occupation. Striae Gravidarum was seen in 48.1%, Linea Nigra 45.9%, Melasma 25.4%, Hirsutism 16.2%, Palmer Erythema 8.1%, Atopic eruption of Pregnancy 11.9%, Polymorphic eruption of Pregnancy 3.2%, Intrahepatic Cholestasis of Pregnancy 1.6%, Pemphigoid gestationis 1.1%, Acne Vulgaris 9.7%, Vulvovaginal candidosis 8.1%, Urticaria 6.5% and Scabies was 5.4%. Practical Implication: We set out to investigate the prevalence of dermatological manifestations during pregnancy, as well as other clinical characteristics affecting pregnant women in Pakistan. Conclusion: If infections during pregnancy are diagnosed at the earliest stage it may prevent morbidity during and after antenatal period. Keywords: Pregnancy; Dermatological manifestations; Frequency, Clinical Patterns, Pemphigoid Gestationis, Acne Vulgaris, Vulvovaginal Candidosis,

Pregnancy and cutaneous changes

Background: Pregnancy is associated with a number of changes in the skin. Some are directly related to pregnancy (dermatoses of pregnancy), some are modified by pregnancy, and yet others are referred to as physiological. We undertook a clinical study to determine the frequency and pattern of skin changes in pregnant females. Materials and Methods: A six-month, multi-centric, cross-sectional study was conducted. A total of 250 pregnant females participated in the study. Detailed history taking and complete dermatological examination were performed. Results were tabulated and analyzed. Results: Physiological skin changes were the most common finding, with pigmentary changes in 98% of the cases. Specific dermatoses of pregnancy were observed in 6.8% of the cases, with atopic eruption of pregnancy being the most common (4.8%). The prevalence of fungal infections was 9.6%. One case of psoriasis was exacerbated by pregnancy. Conclusion: Pregnant females are more likely to experience cutaneous manifestations. In order to establish the diagnosis, thorough history taking and knowledge of the clinical presentation are necessary. Key words: Pregnancy-specific dermatoses; Pregnancy; Physiological changes; Skin

Dermatoses of Pregnancy: Overview of Presentation, Treatment and Outcome

Dermatoses of pregnancy encompass a range of skin disorders that manifest uniquely during the gestational period, characterized by significant itching. This review delves into four primary types: polymorphic eruption of pregnancy, pemphigoid gestationis, atopic eruption of pregnancy, and intrahepatic cholestasis of pregnancy. While atopic eruption and polymorphic eruption are generally benign with no fetal impact, pemphigoid gestationis and intrahepatic cholestasis carry risks for the fetus, including prematurity and stillbirth. Key challenges include the difficulty in early diagnosis of pemphigoid gestationis due to its resemblance to polymorphic eruption and the increased risk of complications like gestational diabetes and pre-eclampsia in intrahepatic cholestasis. Understanding these dermatoses is crucial for prompt diagnosis and effective treatment, to prevent adverse outcomes for mothers and babies and improve the overall pregnancy experience. The review focuses on epidemiology, clinical features, diagnostic methods, maternal and fetal outcomes, treatment options, and comprehensive management strategies for these conditions.

A CLINICAL OBSERVATIONAL STUDY OF SKIN CHANGES SEEN IN PREGNANCY.

Pregnancy is a state of signicant metabolic, endocrinological, immunological and vascular changes which lead to varied cutaneous changes. The cutaneous manifestations could be physiological changes, pregnancy specic dermatoses and skin conditions that are affected by pregnancy. The aim of this study was to nd the incidence of pregnancy dermatoses and characterize the various cutaneous manifestations seen in pregnant women. Methods: It was a cross-sectional descriptive study done over 2-year period from September 2016 to September 2018. All pregnant women presenting to the dermatology outpatient with complaints of skin disorders were recruited for the study. Informed consent was taken and the detailed examination ndings recorded. A total of 200 pregnant women were included i Results: n the study. Mean age was 25.5 years. Majority of participants were primigravida 130(65%). Most common presenting complaint (126 cases, 63%) was itching. Majority of participants (113) presented in the third trimester. Physiological skin changes pertaining to pregnancy was noted in 91(45.5%) participants, 156(78%) had pregnancy non-specic dermatoses and 39(19.5%) had pregnancy specic dermatoses. Hyperpigmentation and striae gravidarum were seen in 24% pregnant women. Among the pregnancy-nonspecic dermatoses infections was the most common condition (76 cases, 38%). Fungal infections constituted the majority, followed by viral and bacterial infections. STI were seen in 5 patients. Polymorphic eruption of pregnancy was the most common pregnancy specic dermatoses seen in 38 (19%) women. Thirty-three of these patients were primi in their 3rd trimester, 5 were in 2nd trimester. Atopic eruption of pregnancy was seen only in 1(0.5%) participant. Hyperpigmentation and stria Conclusion: e gravidarum are the most common physiological changes seen in pregnancy. Pregnancy predisposes to a wide variety of infections of which fungal infections are most common, followed by viral. Polymorphic eruption of pregnancy is the most common pregnancy specic dermatoses.

A cross-sectional study of cutaneous changes during pregnancy in a tertiary care hospital in Northern India

<p class="abstract"><strong><span lang="EN-US">Background: </span></strong><span lang="EN-US">Women undergo profound changes during pregnancy, making them susceptible to a number of dermatological manifestations. We aimed to determine the frequency and pattern of skin changes during pregnancy.</span></p><p class="abstract"><strong><span lang="EN-US">Methods: </span></strong><span lang="EN-US">A cross-sectional observational study was conducted among 400 pregnant women presenting to the Outpatient department of a Tertiary Care Centre in Northern India.</span></p><p class="abstract"><strong><span lang="EN-US">Results: </span></strong><span lang="EN-US">A total of 400 pregnant mothers fulfilling inclusion criteria were included. The pigmentary changes were the most common physiological change seen in 90.8% (n=363) of pregnant women. The most common pigmentary change was secondary areola seen in 83% (n=332) women, followed by linea nigra seen in 37.5% (n=150) pregnant women. Vascular changes were seen in 13% (n=52), non- pitting pedal edema being the most common 10.25% (n=41). Connective tissue changes were seen in 62.25% (n=249) of pregnant women, striae gravidarum being the most common (n=242). The most common specific dermatoses of pregnancy was atopic eruption of pregnancy seen in 4.25% (n=17), followed by intrahepatic cholestasis of pregnancy (n= 14). 3 cases (0.75%) of Polymorphic eruption of pregnancy were seen. 1 case of Pemphigoid gestationis was seen in the third trimester. Approximately 17% of pregnant women were positive for infections among which fungal infection was the most common infection affecting pregnant women, seen in 11.2% (n=45) participants. </span></p><p class="abstract"><strong><span lang="EN-US">Conclusions:</span></strong><span lang="EN-US"> The dermatoses of pregnancy are common and have a range of dermatological manifestations apart from their specific pattern; in order to manage and treat them appropriately, proper attention needs to be given.</span></p>

Pruritus in Pregnancy.

Pruritus in pregnancy is a common and burdensome symptom that may be a first sign of a pregnancy-specific pruritic disease (atopic eruption of pregnancy, polymorphic eruption of pregnancy, pemphigoid gestationis, and intrahepatic cholestasis in pregnancy) or a dermatosis coinciding with pregnancy by chance. Despite its high prevalence, pruritus is often underrated by physicians, and data regarding the safety profiles of drugs for pruritus are very limited. In this review, we illustrate the epidemiology, possible pathophysiology, clinical characteristics, and diagnostic workup of various pregnancy-related diseases and discuss antipruritic treatments. The prevalence of pruritus in pregnancy demonstrates the importance of symptom recognition and the need for an holistic approach, taking into account both the potential benefits for the patient and the potential risks to the fetus.

The spectrum of mucocutaneous manifestation during pregnancy: An observational study of 170 pregnant women visiting a tertiary care hospital

Background: Pregnancy is characterized by myriad of temporary alteration in endocrine, metabolic, and immunological factors. These alterations result in multiple mucocutaneous manifestations. The various skin changes may be either physiological or changes in preexisting skin diseases, or development of new pregnancy-specific dermatoses. Pregnancy-specific skin dermatoses include atopic eruption of pregnancy (AEP), polymorphic eruption of pregnancy, pemphigoid gestationalis, and intrahepatic cholestasis of pregnancy. Aims: The aim of the study was to study the frequency and pattern of mucocutaneous manifestations in pregnant women attending the tertiary care hospital. Settings and Design: A descriptive observational study. Subjects and Methods: A total number of 170 pregnant women attending antenatal outpatient department from October 2017 to March 2019 were included in the study. Detailed history, clinical examination, and relevant investigations were done. Patients not willing to give informed consent were only excluded from the study. Results: In this study, 58.23% (99) were primigravida and 41.77% (71) were multigravida. Most of the cases presented during third trimester (73%). In this study among the 170 pregnant women, the incidence of skin changes observed was 790 physiological entities, nonspecific dermatoses of pregnancy were 95, and 42 cases of specific dermatoses of pregnancy. The most common physiological changes noted were pigmentary changes 46.96% out of all physiological changes. All pregnant women showed pigmentary changes. Most common pigmentary change was linea nigra and melasma. Other changes were striae distensae 14.55%, vascular changes 10.37%, mucous membrane changes 5.19%, pruritus 17%, hair changes 1.51%, and nail changes 1.13%. Tinea corporis was most common infection 48.6% out of all infections, followed by candidal vaginitis 10.8%. Acne vulgaris was most common inflammatory disorder seen in 12.35%, followed by urticaria and psoriasis, seen in 7.05% and 1.76%, respectively. Polymorphic eruption of pregnancy and AEP was seen in 14.70% and 10%, respectively. No cases of intrahepatic cholestasis of pregnancy and pemphigoid gestationalis were noted. Conclusions: This study brings into focus prevalence of various mucocutaneous changes during pregnancy. Thorough knowledge about pregnancy dermatoses is essential to arrive at a specific diagnosis which is a mandate for counseling and management.

Peau et grossesse

Pregnancy has a substantial impact on the hormonal status of the organism, consequently influencing the physiology of the skin. This results in dermatoses that only occur during pregnancy, which can also improve or exacerbate pre-existing dermatoses. In this article, we explain the management of pregnancy-specific dermatoses : atopic eruption of pregnancy, polymorphic eruption of pregnancy, pemphigoid gestationis, impetigo herpetiformis, and intrahepatic cholestasis of pregnancy. It is essential to clearly distinguish these different dermatoses as some of them, such as pemphigoid gestationis, impetigo herpetiformis and intrahepatic cholestasis of pregnancy, can have fetal consequences and as result, need to be closely monitored by the obstetricians.

Assessment and management of itchy skin in pregnancy.

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.

What's in a name? Prurigo versus atopic eruption of pregnancy without atopic history.

What's in a name? Prurigo versus atopic eruption of pregnancy without atopic history.

Atopic Eruption of Pregnancy: A Case Report and Brief Topic Overview

Pruritus is a common symptom during pregnancy and can manifest as a result of multiple conditions. Atopic eruption of pregnancy is the most common dermatosis specific to pregnancy and does not represent a threat to the health of mother or fetus. However, other similar-appearing dermatoses of pregnancy can result in fetal harm or sub-optimal outcomes, hence these must be ruled out in the pruritic pregnant patient. Herein we present a case of atopic eruption of pregnancy and discuss the diagnostic approach to these patients.

A study of dermatoses in antenatal patients attending tertiary care centre

<p><strong>Background: </strong>Pregnancy produces many cutaneous changes which can be either physiological, alteration in pre-existing skin diseases or development of dermatoses which are specific to pregnancy which occur due to the production of a number of proteins and steroid hormones by the fetoplacental unit and maternal pituitary, thyroid and adrenals. Patient’s concern may range from cosmetic appearance to potential effects on mother and fetus. Aims and objectives: Study was undertaken to observe physiological and pathological skin changes in different gravidae and trimesters of pregnancy.</p><p><strong>Methods: </strong>A cross sectional study performed after institutional ethics committee clearance. Total 205 pregnant females were enrolled in study by simple random sampling. Complete history, clinical examination and relevant investigations were done. Patients were treated accordingly. Data was analysed by application of descriptive analysis, Mean and SD.</p><p><strong>Results: </strong>In physiological changes, linea nigra was the most common, followed by striae distensae. Pigmentary changes were found more commonly in 2<sup>nd</sup> trimester while vascular and structural changes were commoner in 3<sup>rd</sup> trimester. In dermatoses affected by pregnancy, fungal infection was most common followed by viral infections and acne which were most commonly seen in 2<sup>nd</sup> trimester. Polymorphic eruption of pregnancy was most common among pregnancy specific dermatoses followed by pruritus gravidarum which were more commonly noted in the 3<sup>rd</sup> trimester. Atopic eruption of pregnancy was common in 2<sup>nd</sup> trimester. As study was cross sectional, disease progression and treatment outcome could not be observed.</p><p><strong>Conclusions: </strong>Cutaneous lesions<strong> </strong>may range from common, benign changes termed physiological or more severe, posing significant risk to mother and child. Timely diagnosis and prompt treatment is essential for improving maternal and fetal well-being and prognosis and to minimize their morbidity.<strong></strong></p>

Pregnancy dermatoses - a study of patients attending antenatal clinic at two tertiary care centers in south west Nigeria

INTRODUCTION: Pregnancy is associated with many systemic changes mostly linked with hormones. The skin shows many of these changes as dermatoses - directly related to the pregnancy or an exacerbation/amelioration of a prenatal condition. A few of the pregnancy dermatoses can be fatal if unrecognised early. The aim of this study was to document the spectrum of pregnancy dermatoses and effect on quality of life of pregnant women presenting at the antenatal clinics of two tertiary hospitals in South west Nigeria. METHODS: a prospective observational cohort study carried out concurrently at the antenatal clinics of two tertiary hospitals: Lagos University Teaching Hospital (LUTH) and Olabisi Onabanjo University Teaching Hospital (OOUTH) over seven months. Consecutive patients filled questionnaires and had full dermatology examination by specialists with results documented and analysed with SPSS 21st edition. RESULTS: of 296 patients studied, 175; 59.1% first presented for antenatal clinic in the 3rd trimester. Most common symptom was itching (125; 42.2%) and 85.5% had signs of dermatoses. Atopic eruption of pregnancy (AEP) and pruritic urticarial papules and plaques of pregnancy were seen in (11; 3.7%) of patients. A background history of atopic dermatitis was significantly associated with AEP. The most common non-specific pregnancy dermatoses were acne vulgaris (129; 43.6%), superficial fungal infections (119; 40.2%) and melasma (55; 18.6%). CONCLUSION: skin conditions are common in pregnancy; fatal pregnancy dermatoses were not seen in this study.

Clinical Spectrum of Pregnancy Related Dermatoses in a Tertiary Care Hospital in Western India

Introduction: Pregnancy is characterized by altered endocrine, metabolic, and immunologic milieus resulting in multiple cutaneous changes, both physiologic and pathologic. This research was undertaken to study physiological changes of pregnancy and prevalence of various pregnancy specific and non-specific dermatoses. Methodology: A retrospective study was conducted at the dermatology out-patient department of a tertiary care center in western India and data of 308 pregnant patients presenting with dermatoses, in the age-group of 19-35 years was analyzed. Detailed history, clinical examination and necessary investigations were reviewed. Results: Among 308 patients, 302(98.05%) presented with physiological skin changes of pregnancy, 118(38.31%) had pregnancy specific and 185(60.06%) had pregnancy non-specific dermatoses. The most common physiological change was pigmentary changes (n=294). Atopic eruption of pregnancy (n=79) was the most common pregnancy specific dermatoses followed by polymorphic eruption of pregnancy (n=38). In non-specific dermatoses, infectious diseases were more common (fungal, n=128; viral, n=25). Conclusion: Pregnancy non-specific dermatoses were seen more commonly than pregnancy specific dermatoses. Lower socioeconomic strata and overcrowding may be the reasons behind large number of infectious dermatoses that we saw in our study.

The complex implications of dermatoses specifically associated with pregnancy

Pregnancy-specific dermatoses are a heterogeneous group of inflammatory dermatoses associated exclusively with pregnancy. Although these dermatoses are rare, it raises problems in medical practice because of their appearance, being difficult to diagnose, treat and the possibility of the fetus being affected. Pemphigoid Gestationis (PG) is a rare, autoimmune, strongly pruritic, vesiculobullous dermatosis with a strong impact on the patient. Polymorphic Eruption of Pregnancy (PEP) is a benign, self-limited inflammatory skin disorder that usually affects first pregnancy in the third trimester or immediately in the postpartum period. Other dermatoses associated with pregnancy include: Intrahepatic Cholestasis of Pregnancy (ICP), Atopic Eruption of Pregnancy (AEP) and Pruritic Folliculitis of Pregnancy (PFP). We will extensively present PG and PEP, to draw attention to the importance of correct diagnosis and the implications of treatment during pregnancy.

Dermatoses of pregnancy. A prospective study from Benghazi, Libya

Introduction: Cutaneous findings in pregnancy can be physiologic, coincidental, alterations in pre-existing skin diseases or pregnancy specific. The Pregnancy dermatoses can impact the health of the pregnant woman and the fetus Objectives: Our objective was to determine the spectrum of skin disease associated with pregnancy and to identify the various types of pregnancy specific dermatoses and their fetal risk. Materials & methods: A prospective study was performed at dermatology out-patient department of Jumhoria hospital and Ibn Sina polyclinic, Benghazi-Libya over a period of 2 years. A total of 200 pregnant women presented with dermatological complaint were included. History, skin examination, and relevant investigations were performed. The patients with pregnancy specific dermatoses were followed up till delivery and the pregnancy outcome was recorded. The results were analyzed using SPSS. Results: Mean age was 32 years, 62% was multigravidae and 54% of pregnancy dermatoses occurred during third trimester. The highest number of cases presented with coincidental or preexisting diseases (71%); infections (34%), pre-existing skin diseases included eczema (13%), acne vulgaris (4%) and psoriasis (3%) Hyperpigmentation and strieagravidarum represented the main physiological changes (17%). Specific pregnancy dermatoses were present in 12%, these were intrahepatic cholestasis of pregnancy (4%), atopic eruption of pregnancy (3%), pemphigoid gestationis (3%) and polymorphic eruption of pregnancy (2%). Fetal complications including fetal mortality were reported with pemphigoid gestationis (30%) and intrahepatic cholestasis of pregnancy (25%). Conclusions: This study provides important data on the spectrum of pregnancy dermatoses in Libyan patients. Most of the reported pregnancy dermatoses were benign with no adverse effect on the fetus. Pemphigoid gestationis and intrahepatic cholestasis of pregnancy can be a source of significant fetal risk. To the best of our knowledge this is the first study carried out on pregnancy dermatoses in Benghazi, Libya.

Pruritus in pregnancy – is it always obstetric cholestasis?

The article discusses four types of pruritus in pregnancy: intrahepatic cholestasis of pregnancy (ICP), polymorphic eruption of pregnancy (PEP) (also known as pruritic urticarial papules and plaques of pregnancy (PUPPP), atopic eruption of pregnancy (AEP) and pemphigoid gestationis (PG). The midwife will differentiate between the types, knowing to refer ICP and PG to the multidisciplinary team, while enabling women with self-management for PEP and AEP.

Specific dermatoses of pregnancy other than pemphigoid gestationis

Specific dermatoses of pregnancy are skin disorders that occur specifically during or immediately after pregnancy and cannot be found in non-pregnant patients. According to the current consensus, they include atopic eruption of pregnancy (AEP), polymorphic eruption of pregnancy (PEP), pemphigoid gestationis (PG), and intrahepatic cholestasis of pregnancy (ICP). The diagnosis of specific dermatoses of pregnancy can be challenging due to their variation in clinical presentation; moreover, the tests currently available do not always provide the clue for the diagnosis. However, some distinctive features may be helpful to differentiate between such entities. Accordingly, the knowledge of specific dermatoses of pregnancy and of their management is critical, since their early recognition may allow to provide care for the mother and prevent potential increased fetal risk. In fact, while AEP and PEP do not affect maternal and fetal prognosis, PG and, mainly, ICP are associated to maternal complications as well as the risk of fetal loss. In this paper, the epidemiology, pathogenesis, clinical features as well as management of AEP and PEP are reviewed in detail, while PG is described in another article of this issue. Moreover, the main features of ICP, which cannot be considered a primarily skin disease but may be managed first by dermatologists, are reported.