Dermatosis of pregnant women is a lesion of the skin that develops in a woman only during the period of gestation. Within nine months, the body changes the hormonal background. The growing fetus affects the functioning of the immune system and blood circulation. What’s more, during pregnancy sebaceous and sweat glands work more actively. Prurigo of pregnancy is one of the skin diseases that occurs during the gestation period. Many women facing this disease wonder how to deal with this problem. Let’s try to make it clear.
Dermatoses of Pregnant Women
Dermatoses of pregnant women is infrequent manifestation of early gestosis. This is a group of various skin diseases that occur only during pregnancy. Dermatoses are characterized by local or total painful itching. Dermatosis often occurs in the form of prurigo of pregnancy. Eczema, urticaria, erythema, and herpetic rashes develop less often. Factors of pathogenesis are the following: mental stress, sensitization, allergy, exacerbation of latent viral infections, cholestasis, and hormonal alteration.
Prurigo of Pregnancy
This is a disease from the group of itchy dermatoses, characterized by the appearance of swollen nodules with a sharp itch.
Prurigo of pregnancy is clinically manifested by a rash on the skin (predominantly on the extensor surfaces of the upper and lower extremities, buttocks) of small, pin-shaped, itchy, dense nodules with a bubble at the apex, and also wheals. The disease passes itself within 2-4 weeks. But sometimes it lasts up to 3-4 months.
In all languages of the world this disease is pronounced equally – prurigo. This name comes from the Latin word “itching.” In fact, prurigo is 100% justified by the name given to it, because it is a disease that causes itching and the appearance on the skin of nodules of an extremely unpleasant kind.
Prurigo can be called in another way – itching dermatosis, because all skin diseases characterized by the appearance on the rash caused by allergens are implied by this term. Despite the ugly look, prurigo is not contagious. This is a great advantage.
Prurigo of pregnancy occurs at an earlier time (from the 25th to the 30th week) and has no urticarial character, unlike polymorphic dermatosis. The clinical picture is characterized by disseminated itching pruriginous eruptions in the form of excoriated nodules with a hemorrhagic crust on the apex. The rash persists throughout the pregnancy. It should be noted that it is difficult to treat it. At the same time, it usually disappears within a month after birth. But if a woman has an opportunity to take antihistamines, then prurigo of pregnancy usually completely disappears due to these medications.
Causes of Appearance of Dermatosis in Pregnant Women
The causes of dermatosis in pregnant women are not fully established. But most doctors “blame” the disruption of the immune system for such problems. The fact is that the developing of the fetus leads to an intensified synthesis of specific lymphocytes. By the end of the second trimester – the beginning of the third, their number is much greater than normal. As a result, the body begins to react not only to foreign pathogenic cells, but also to its own. Such a state is aggravated by the following reasons:
- overweight, which is often accompanied by increased sebum secretion;
- nervous experiences, which are compulsory companions of even a successful pregnancy;
- pathology of the endocrine system (diabetes mellitus), viral and fungal skin lesions, propensity to acne;
- prolonged toxicosis;
- clothing made of synthetic fabrics;
- consumption of food products prone to cause an allergic reaction;
- stretching of the skin because of an increase of the uterus or a sharp weight gain.
Diagnosis of the exact form of dermatosis in pregnancy is difficult. In the blood test, the changes in the main indicators correspond to the gestation period (this is a moderate increase in ESR and leukocyte level). In most cases, pathogenic flora is not found in the tests results. At the same time, in the immunogram, the concentration of IgG and IgE can increase.
Symptoms of Prurigo of Pregnancy
The disease manifests itself as the appearance of skin rashes in the form of scattered and numerous papules. After some time, bubbles appear on the surface of these nodules. Then they burst, and on their place there are pinpoint erosions, crowned with serous crusts.
Intense itching, which is an invariable companion of prurigo, provokes scratching of the wounds, which, naturally, does not have the best effect on the condition of the diseased skin: scratch marks covered with bloody crusts are formed on the papules. In some severe cases, such nodules are covered with warty growth.
Symptoms of the disease can be complicated by such neuropsychic disorders as capriciousness, tearfulness, poor sleep and increased irritability.
Prurigo rashes are typical for the skin of the body and face, but the favorite places of their dislocation are the extensor surfaces of the extremities. Often these papulovecicles occur on the palms and soles: here they acquire a much larger size – up to 7 mm – and an inflammatory rim.
Prurigo of pregnancy is found in one of 300 pregnant women. This condition is characterized not only by itching, but also by the appearance of rashes in the form of small nodules (papules), mainly on the legs and hands, and also on the abdomen. Prurigo can occur in any trimester. For pregnancy and fetus, this condition is not dangerous. Although it is very unpleasant. Treatment is usually symptomatic, but most often it is ineffective.
Principles of Diagnosis of Pregnancy Dermatosis
In addition to the clinical picture and changes in a number of blood indicators, the appearance of dermatoses can be determined by studying the histological structure of the rashes and changes in the skin. All dermatoses have a specific histological picture, but not all doctors recommend and not all women agree to a biopsy of the skin during pregnancy.
One should understand that there are a large number of diseases that can be accompanied by itching and rashes on the skin. Therefore pregnancy dermatoses are diagnoses of exclusion rather than the primary ones, even in spite of their prevalence. In many cases, first, it is necessary to exclude infectious diseases (one of the most common is scabies), an allergic reaction, liver diseases (viral hepatitis), kidney disease, blood (polycythemia, lymphoma) and other diseases. One must take into account the histories of past pregnancies, as well as personal and family history.
In conclusion, in general, pregnancy dermatoses are not dangerous diseases, although usually accompanied by an extremely unpleasant symptom – itching. This creates discomfort, disturbs the sleep and peace of the woman, and causes additional stress. In such cases, it is necessary to find the best course of action to alleviate the condition of a pregnant woman.
Doctors emphasize that all types of dermatosis arising during pregnancy do not have a pathological effect on the development of the fetus. However, itching disturbs a woman. Sometimes it causes sleep disturbances. In addition, wounds from itching are the “entrance gate” for infections. This can cause complications in the form of acne or boils. To facilitate dermatosis in pregnant women, antihistamines are considered to be the safest means. Their use in the form of ointments is not advisable, since the rash covers too large areas of the skin. Therefore doctors usually prescribe pills.
Sedatives are also used in the treatment of dermatoses during pregnancy. To avoid exposure to the central nervous system of the fetus, doctors prescribe plant extracts.