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Psoriasis and pregnancy: hormone and immune system interaction
A S Boyd1, L F Morris, C M Phillips
1Department of Dermatology, Vanderbilt University, Nashville, Tennessee 37232-5227, USA.
Background:
Various hormonal states are known to be associated with the waxing and waning of psoriasis. Patients with psoriasis commonly experience changes in their cutaneous disease during pregnancy or post partum.
Objective:
We evaluated 100 women with psoriasis by questionnaire and interview. The women had been seen at the Baylor Psoriasis Center, Dallas, and had experienced a pregnancy while having psoriasis. The answers were sorted and tabulated. In addition, we reviewed the literature to ascertain possible causes of clinical changes in psoriasis during pregnancy.
Results:
Ninety questionnaires were completed. Sixty-nine women (76.7%) described a change in their psoriasis during pregnancy with 57 (63.3%) noting improvement. Seventy-nine patients (87.7%) had a postpartum flare, most within 4 months of delivery.
Conclusions:
The majority of women with psoriasis, who become pregnant, experience a change, usually an improvement, in their cutaneous disease. Pregnancy is associated with hormonal changes in estrogens and progesterone resulting in a state of altered immune surveillance.