Polymorphic dermatosis of pregnancy

Expecting a baby is a testing period for a woman, because many transformations occur with the expectant mother: both good and not so. During pregnancy, chronic diseases may worsen or new problems may arise that have never bothered the woman before. Polymorphic dermatosis of pregnancy is just such an ailment, which is provoked exclusively by changes occurring in the body of the expectant mother.

The disease has other names - toxic erythema of pregnancy, itchy urticarial-papular dermatosis, plaque dermatosis of pregnancy and belongs to a group of dermatoses that occur in pregnant women. The frequency of its occurrence is as follows: one case per two hundred and forty expectant mothers. Some experts believe that this type of dermatosis occurs more often - one abnormal pregnancy with skin problems per one hundred and twenty healthy pregnancies.

The appearance of this kind of problem is typical for the third trimester of expectation of the baby. In the overwhelming majority of cases, polymorphic dermatosis affects primiparous women and very rarely - those who are pregnant for the second time. Most often, such skin rashes appear in the thirty-sixth week of expectation of the baby or one or two weeks before delivery. In some cases, the occurrence of dermatosis in the postpartum period is noted, but such cases are quite rare.

It is important to note that such skin problems do not have any complications for the health of the mother and her future baby. Even toxic adverse effects are excluded, which gives the pregnant woman a reason for optimism and allows her to more easily endure the ailments of this period psychologically.

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Causes of polymorphic dermatosis of pregnancy

In the vast majority of cases, all health problems in expectant mothers arise due to a sharp and rapid change in hormonal levels. Such metamorphoses affect all processes in the female body, and first of all, metabolism. Changes in the metabolic processes of a pregnant woman affect some external and internal transformations, one of which is an increase in her body weight. This is a completely normal phenomenon for pregnancy because in the mother's body, not only the fetus grows every day, but also the uterus, placenta, the amount of amniotic fluid increases, and so on.

But it happens that the maternal weight acquires abnormal figures - it increases greatly contrary to the normal parameters of weight gain during this period. This happens due to the same metabolic disorders of the pregnant woman, as well as due to the fact that her chronic diseases that cause excess body weight are exacerbated. In addition, one cannot discount the good appetite of expectant mothers, many of whom eat so much during pregnancy that it begins to greatly harm not only their appearance, but also their well-being.

Excessive amounts of food, especially sweet and floury dishes, fatty and fried foods, as well as smoked foods, etc., lead to the fact that not only the pregnant woman begins to gain extra pounds. Such insatiable eating affects the increase in the weight of the fetus, leading to its abnormal increase.

All of the above - excess maternal weight and high fetal body weight - are precisely the causes of polymorphic dermatosis of pregnancy that are known to specialists. At the same time, it is important to know that multiple pregnancy, in which the weight of the pregnant woman naturally increases, is a provoking factor for the development of the disease.

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Symptoms of polymorphic dermatosis of pregnancy

The symptoms of this skin disease are very clear and, most importantly, unpleasant for the expectant mother. Which, firstly, facilitates the diagnosis of the disease, and secondly, helps to choose the right and timely therapeutic means.

Symptoms of polymorphic dermatosis of pregnancy are as follows:

• The initial area of the rash is on the abdomen, with further spread to other areas of the skin.
• The navel area is not affected.
• Localization of skin problems on the skin of the abdomen, buttocks and thighs. Less often - on the upper and lower extremities, palms and feet, chest, and also the face of a woman.
• The appearance of rashes in this area, which resemble urticaria in appearance. These rashes are called papules. The papules that form are red, edematous and erythematous in appearance, and are from one to three millimeters in size.

After their appearance, the rashes merge in a very short time and form plaques that resemble large blisters. Sometimes, confluent polycyclic lesions are formed from plaques. In some cases, vesicles - small bubbles with liquid - are formed on the affected areas of the skin.

• There are clear boundaries of the rash.
• The appearance of severe itching in the affected area.
• Half of the cases of papules appear on striae, which are stretch marks on the skin after a pregnant woman's volume increases.
• No damage to mucous membranes.

The nature of the disease is as follows: rashes appear and progress over one or two weeks. Itching sensations are present in the abdominal area, striae often begin to itch – skin stretch marks. The nature of the itching becomes so strong that it interferes with the pregnant woman’s night sleep, as well as her normal well-being during the day.

Fading, that is, the complete disappearance of the rash occurs immediately after birth and is observed for one week to ten days.

Diagnostics

Diagnosis of polymorphic dermatosis of pregnancy is not difficult. The clinical picture is so clear that even during examination of the patient, a specialist can make the correct diagnosis.

In differential diagnostics, it is important to distinguish polymorphic dermatosis from other clinically similar diseases of pregnant women:

• herpes of pregnancy,
• drug toxicoderma,
• diffuse neurodermatitis.

This type of disease may require laboratory tests. The following tests are usually prescribed:

• complete blood count,
• serological blood test,
• biochemical blood test,
• performing a biopsy of the affected tissue area.

When processing the results of the blood test, no deviations from the norm are revealed. The results of the biopsy are the detection of perivascular lymphohistiocytic infiltration, which is localized in the upper layers of the dermis. Also, during the tissue biopsy, the presence of parakeratosis is established - a violation of the keratinization of cells due to the loss of their function of keratin production. And the last thing that a biopsy can be useful for is the detection of spongiosis, which is an exudative inflammatory process in the epidermis. In this case, serous fluid begins to accumulate in the intercellular space of the spinous layer of the skin, which leads to an increase in intercellular lacunae.

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Treatment of polymorphic dermatosis of pregnancy

Among the medications prescribed to expectant mothers, the following drugs can be distinguished:

• Taking sedatives (or tranquilizers).

Approved medications during pregnancy include motherwort, valerian and other sedatives that are not infused with alcohol.

• Use of antihistamines.

The above medications are prescribed orally. They stabilize the nervous system of a pregnant woman and also help minimize allergic reactions of the body. Sedatives help relieve tension accumulated during the day by unpleasant sensations in the abdomen and experience a deep and healthy sleep at night.

Among the external remedies recommended for use, the following should be highlighted:

• Mixtures with antipruritic effect that need to be shaken.
• Creams containing calamine, which is a zinc oxide.
• Corticosteroid ointments and creams.

Sometimes, when a case of polymorphic dermatosis is particularly severe, a specialist may prescribe oral Prednisone in the amount of forty grams per day.

Prevention

Not all diseases can be prevented with 100% measures. Prevention of polymorphic dermatosis of pregnancy is one of the same complex tasks. Of course, a pregnant woman needs to take certain steps to avoid provoking such an unpleasant skin disease. But, still, it is impossible to guarantee that if all the rules and regulations are followed, the expectant mother will avoid skin problems in the last trimester of pregnancy.

So, in order to reduce the risk of developing the disease, a woman needs to monitor her weight and lead a healthy lifestyle. Preventive procedures related to nutrition are as follows:

• Eliminate sweets, flour and confectionery products, white bread and pasta from their menu.
• Stop eating fatty foods, as well as dishes with a lot of vegetable oils and animal fats.
• Change the cooking technology. Instead of frying, it is better to steam, boil or stew food.
• Get rid of canned and pickled foods.
• Stop eating overly salty foods and spicy dishes for a while.
• Introduce a large amount of plant food into your diet, preferably fresh and in season. It is important to eat as many different vegetables, fruits, berries and greens as possible. At the same time, you need to pay attention to your well-being in order to avoid allergic reactions to this food.
• Drink enough clean water.
• Eliminate coffee, black and strong tea, and carbonated drinks from consumption.
• Try not to eat two hours before going to bed.

Measures that help stabilize excess weight include feasible physical exercises:

• Walks in the fresh air – in squares and parks, near bodies of water.
• An evening half-hour walk before bed.
• Light gymnastic exercises that can be done during pregnancy.

It is also important to ensure that the skin breathes well and is clean. Therefore, it is important to follow these rules:

• Wear clothes made only from natural materials.
• Avoid dressing too warmly to avoid skin chafing.
• Take a hygienic shower every day.
• To prevent stretch marks, use oils and body products that are recommended for pregnant women.

Forecast

Many diseases that arise during pregnancy disappear immediately after childbirth. Polymorphic dermatosis is no exception: within ten days after the baby is born, the young mother notices the disappearance of all unpleasant skin symptoms.

Most often, the disease does not relapse. But if, nevertheless, skin problems return, their symptoms are much less pronounced, which indicates a milder course of the disease. Although most women note that after childbirth, skin problems do not occur, even when taking oral contraceptives. And subsequent pregnancies also pass without dermatoses that tormented the woman during the period of expectation of the first child. Therefore, it can be said that the prognosis of polymorphic dermatosis of pregnancy is positive in almost one hundred percent of cases.

Specialists conducted studies that examined the impact of this disease on the quality of pregnancy. As a result of work on this topic, it was found that polymorphic dermatosis does not in any way affect the post-term or pre-term pregnancy, or the occurrence of spontaneous abortions. In addition, there are no congenital anomalies in children of women who suffered from the disease during pregnancy. Therefore, the skin problem of expectant mothers is not considered dangerous either for the future child or for the woman herself. In obstetric practice, only one case of stillbirth has been described - from a pair of twins, but the causes of stillbirth are in a completely different plane, not from the area of skin diseases of the mother.

Polymorphic dermatosis of pregnancy is an unpleasant skin disease that can cause a lot of trouble for a woman. But there is no need to worry that such problems will now be with a woman constantly. The time of childbirth will pass, and after such an exciting event, the body of the young mother will naturally cope with the skin problem, which will disappear forever.

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