在怀孕和母乳养期间治疗皮肤病:系统性审查
Lindsey J Wanberg1, Benjamin G Gorman2, Nicole Theis-Mahon3
1University of Minnesota Medical School, Minneapolis, MN, USA.
International journal of dermatology
|August 1, 2024
概括
在怀孕期间的皮肤病 (PG) 缺乏指南. 系统性皮质类固醇显示成功,但带有风险;局部治疗和TNF抑制剂是孕妇或哺乳期PG患者的首选.
科学领域:
- 皮肤病学 皮肤病学
- 产科 产科 产科 产科 产科
- 药理学 药理学是指药理学的学科.
背景情况:
- 炎症性皮肤病 (PG) 是一种自身炎症性皮肤疾病.
- 怀孕是PG的疑似危险因素,但没有治疗指南.
- 关于在怀孕或哺乳期患者中管理PG的数据有限.
研究的目的:
- 系统地审查有关妊娠和母乳养期间PG治疗的文献.
- 在这个人群中确定PG的有效和安全的治疗选择.
- 为孕妇或哺乳期PG患者提出治疗算法.
主要方法:
- 在四个数据库进行系统文献审查 (2022年10月完成).
- 独立审查员进行选和数据提取.
- 包括18篇详细介绍孕妇或哺乳期患者PG治疗的文章.
主要成果:
- 大多数PG病例 (77.7%) 缺乏先前病史;大多数 (61.1%) 没有PG并发症.
- 系统性皮质类固醇 (SCS) 在73%的孕妇患者中取得了治疗成功.
- 包括早产在内的不良结果 (16.7%),与SCS>0.5 mg/kg/day在怀孕期间有关.
结论:
- 由于安全性更好,建议在孕妇/哺乳期PG患者使用局部治疗和TNF抑制剂.
- 数据的稀缺性需要对PG疗法进行受控研究和怀孕登记册.
- 建议采用一种治疗算法,以指导怀孕和母乳养期间PG的管理.
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