Psoriasis during pregnancy: characteristics and important management recommendations

Abstract

The treatment of psoriasis in pregnant women can be challenging. Psoriasis generally improves during pregnancy; however, many pregnant patients still require treatment. In treating pregnant patients, the benefits of treatment and risks to the mother and the fetus must be considered. For localized psoriasis, topical corticosteroids are the treatment of choice. Other topical agents that are approved for the treatment of psoriasis, such as topical tar products and topical tazarotene, should be avoided during pregnancy because of unclear risks of teratogenicity. For moderate-to-severe psoriasis, ultraviolet B phototherapy is preferred. Despite limited safety data, biologics are favored over other systemic medications when needed. While there are new treatment options for psoriasis, there is limited information on the safety of medications during pregnancy.

Keywords: acitretin; apremilast; coal tar; corticosteroid; cyclosporine; etanercept; infliximab; methotrexate; pimecrolimus; pregnancy; psoriasis; salicylic acid; secukinumab; tacrolimus; therapy; ustekinumab.