A screening study on dermatoses in pregnancy.

INTRODUCTION : Pregnancy is characterized by altered endocrine, metabolic, and immunologic milieus. These dramatic alterations result in multiple cutaneous changes, both physiologic and pathologic. These alterations may range from normal cutaneous changes to eruptions that appear to be specifically associated with pregnancy. Moreover, pregnancy may modify the course of a number of dermatological conditions. Likewise, the concerns of the patient may range from cosmetic appearance, to the chance of recurrence of the particular problem during a subsequent pregnancy, to its potential effects on the fetus in terms of morbidity and mortality. The present study was undertaken to find out the prevalence of the physiological and pathological skin changes in pregnancy. AIM OF THE STUDY : 1. To study the prevalence of physiological cutaneous changes in pregnant women. 2. To study the prevalence of specific dermatoses of pregnancy. 3. To study the prevalence of various infective and miscellaneous cutaneous diseases in pregnancy. 4. To correlate the prevalence of the major cutaneous changes and diseases in relation to different trimesters of pregnancy and with gravidity. CONCLUSION : 1. In this study, the prevalence of physiological skin changes in pregnant women was 94.8%, with pigmentary changes being the most common (90.8%), followed by striae gravidarum (79.6%), vascular changes (23.6%), miliaria (13.6%), hair changes (1.6%) and nail changes (0.8%). 2. The prevalence of specific dermatoses of pregnancy was 14%. Pruritus gravidarum was the most common disease encountered (10.4%), followed by prurigo of pregnancy (1.8%), pruritic urticarial papules and plaques of pregnancy (1.6%) and pruritic folliculitis of pregnancy (0.2%). 3. The prevalence of infections was 30.8%. The most common infection observed in our study was fungal infection (23.8%), followed by viral (4%) and bacterial (1.2%) infections. Pityriasis versicolor was the most common fungal infection observed (10.6%), followed by candidiasis (8%). 4. The miscellaneous dermatoses observed in this study in the order of prevalence were acne vulgaris (10.4%), insect bite allergy (6%), acanthosis nigricans (0.4%), pityriasis rosea (0.4%), antiphospholipid antibody syndrome (0.4%), psoriasis (0.2%), impetigo herpetiformis (0.2%) and urticaria (0.2%). Exacerbation of systemic lupus erythematosus and neurofibromatosis during pregnancy was observed in 0.6% and 0.4% respectively. 5. Compared to multigravidas, primigravidas had a statistically significant proportion of pigmentary changes, striae gravidarum and specific dermatoses of pregnancy. Significantly higher proportion of vascular changes, striae gravidarum and specific dermatoses of pregnancy was observed in third trimester