Pruritic folliculitis of pregnancy

We studied the clinical and pathologic features of a pruritic, erythematous, papular eruption occurring in six pregnant women between the fourth and ninth months of gestation. All patients were in good health and without symptoms associated with the eruption. The lesions were generalized except in one patient. The clinical diagnosis in each case was papular dermatitis of pregnancy. The histopathologic feature of acute folliculitis was observed in five of the six women. The sixth patient demonstrated parakeratosis limited to the acrotrichium. No microorganisms were found in the six patients, and direct immunofluorescence microscopy was negative for deposition of immunoreactants in the four patients that were observed. Deliveries were normal, and all infants were healthy. The lesions cleared spontaneously at delivery or in the postpartum period. We believe that papular skin lesions in pregnant women should undergo biopsy to obtain further data regarding the dermatitis and its natural history.