[Specific dermatoses of pregnancy]

A heterogenic group The dermatoses specifically associated with pregnancy are generally benign, even if they lead to great discomfort. Some of them require appropriate management because of the risk of maternal or foetal complications. Pruritus of pregnancy Corresponds to intra-hepatic cholestasis of pregnancy, present in 1 to 2% of pregnant women, it may place the foetus at risk of delayed growth, prematurity or even death in utero. Treatment relies on cholestyramine. Pemphigoid gestationis or herpes gestationis This is an autoimmune disease of pregnancy occurring in multiparous women between the 28th and 32nd week of amenorrhoea (once out of 5 times within the first 7 days postpartum). Diagnosis is confirmed by histological examination of a bullous lesion. The disease usually regresses spontaneously after delivery, generally within a period of 1 to 17 months. Relapses, earlier on and more severe than during the initial episode, occur in 50 to 70% of subsequent pregnancies. Treatment is essentially based on corticosteroids: local Class II for the pauci-bullous and/or limited forms and general corticosteroid therapy for the severe forms. Polymorphic dermatitis of pregnancy This regroups various and similar entities described during pregnancy. They start during the third trimester of pregnancy, their clinical aspects are similar, their histology is non specific, the biological explorations are normal, direct immunofluorescence is negative, the progression is favourable for the mother and the child and the pathogenesis is unknown. Impetigo herpetiformis This exceptional dermatosis affects the primiparous woman in 80% of cases and the eruption usually appears during the 3rd trimester of pregnancy, or even after delivery. Relapses are constant during subsequent pregnancies.