妊娠期皮肤病（英文版）.ppt

Pregnancy dermatoses 2009.08.11 Physiologic skin changes in pregnancy Dermatoses exacerbated by pregnancy Dermatoses only occurring in pregnancy Specific dermatoses of pregnancy Physiologic skin changes in pregnancy妊娠期皮肤的生理变化 Hyperpigmentation 色素沉着 Occurs in 90% of pregnant women Increased melanocyte-stimulating hormone Accentuation on areolae, genital skin, and linea alba Usually regresses postpartum Melasma 黄褐斑 Occurs in 70% of pregnant women Also seen with oral contraceptivetherapy Centrofacial, malar, and mandibular patterns Excessive melanin in epidermis or dermal macrophages Worsens with UVB exposure Hirsutism 多毛症 Face, limbs, and back Regresses within 6 months postpartum Slowed conversion from anagen to telogen hairs Nail changes 甲改变 Transverse grooving Brittleness Distal onycholysis Increased eccrine gland activity 内分泌腺活性增加 Miliaria Dyshidrotic eczema Hyperhidrosis Decreased apocrine gland activity大汗腺活动性减少 Hidradenitis suppurativa alleviated Increased sebaceous gland activity 皮脂腺活动性增加 Exacerbation of acne vulgaris Montgomery’s tubercles enlarge Striae distensae妊娠纹 Occur in 90% of pregnant women Pink or purple atrophic longitudinal bands Caused by increased adrenocortical activity Fade postpartum to persistent pale atrophic bands Vascular changes血管变化 Spider nevi Palmar erythema Nonpitting facial edema Venous varicosities: Legs Vasomotor instability Dermographism Edema and hyperemia of gingivae Dermatoses exacerbated by pregnancy妊娠期加重的皮肤病 Atopic eczema 特应性皮炎 May deteriorate or remit during pregnancy limbs and/or trunk and face May present for the first time in pregnancy in predisposed person Irritant hand dermatitis and nipple eczema common postpartum Treatment: topical corticosteroids, emollients, UVB Psoriasis 银屑病 Most common type : chronic plaque psoriasis Differential diagnosis of pustular variant from impetigo herpetiformis may be difficult Topical treatment: Dithranol, calcipotriol, tar, and corticosteroids are all safe in pregna