[Dermatological diseases influenced by pregnancy]

Area of Science:

• Rheumatology
• Obstetrics
• Dermatology

Context:

• Pregnancy significantly impacts several autoimmune and connective tissue diseases.
• Systemic lupus erythematosus (SLE) flares occur in 60% of pregnancies, with renal damage and hypertension being key prognostic factors.
• Neonatal lupus risk is linked to anti-Ro-SSA and anti-La-SSB antibodies, posing an unpredictable threat.

Purpose:

• To review the influence of pregnancy on various autoimmune and connective tissue disorders.
• To highlight potential risks and management strategies for pregnant patients with these conditions.
• To emphasize the necessity of multidisciplinary surveillance for lupus patients planning pregnancy.

Summary:

• Systemic lupus erythematosus (SLE) flares are common during pregnancy, affecting 60% of cases and posing risks like prematurity and neonatal lupus.
• Other connective tissue disorders such as scleroderma and dermatopolymyositis may be exacerbated by pregnancy, particularly with renal involvement.
• Bullous diseases like porphyria and pemphigus can appear or worsen during pregnancy, while sarcoidosis has a negligible impact.
• Various genetic conditions including Ehlers-Danlos syndrome and neurofibromatosis can lead to complications during pregnancy.
• Genital infections and varicella pose significant risks to both mother and infant during pregnancy.

Impact:

• Highlights the critical need for specialized, multidisciplinary care for pregnant women with autoimmune diseases.
• Informs clinical practice regarding risk assessment and management of pregnancy in patients with connective tissue and bullous disorders.
• Underscores the importance of monitoring for fetal complications such as prematurity and neonatal lupus.