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Review
. 2021 Aug 5;57(8):804.
doi: 10.3390/medicina57080804.

State-of-the-Art Review of Pregnancy-Related Psoriasis

Anca Angela Simionescu  1 , Bianca Mihaela Danciu  2 , Ana Maria Alexandra Stanescu  3
Affiliations
Review

State-of-the-Art Review of Pregnancy-Related Psoriasis

Anca Angela Simionescu et al. Medicina (Kaunas). .

Abstract

Psoriasis is a chronic immunologic disease involving inflammation that can target internal organs, the skin, and joints. The peak incidence occurs between the age of 30 and 40 years, which overlaps with the typical reproductive period of women. Because of comorbidities that can accompany psoriasis, including metabolic syndrome, cardiovascular involvement, and major depressive disorders, the condition is a complex one. The role of hormones during pregnancy in the lesion dynamics of psoriasis is unclear, and it is important to resolve the implications of this pathology during pregnancy are. Furthermore, treating pregnant women who have psoriasis represents a challenge as most drugs generally prescribed for this pathology are contraindicated in pregnancy because of teratogenic effects. This review covers the state of the art in psoriasis associated with pregnancy. Careful pregnancy monitoring in moderate-to-severe psoriasis vulgaris is required given the high risk of related complications in pregnancy, including pregnancy-induced hypertensive disorders, low birth weight for gestational age, and gestational diabetes. Topical corticosteroids are safe during pregnancy but effective only for localised forms of psoriasis. Monoclonal antibodies targeting cytokines specifically upregulated in psoriasis, such as ustekinumab (IL-12/23 inhibitor), secukinumab (IL-17 inhibitor) can be effective for the severe form of psoriasis during pregnancy. A multidisciplinary team must choose optimal treatment, taking into account fetal and maternal risks and benefits.

Keywords: gestational diabetes; high-risk pregnancy; hypertensive disorders; low birth weight; pregnancy; psoriasis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Psoriasis Vulgaris after use of keratolytic agents: skin plaques located on the lower back.
Figure 2
Figure 2
(A) Patient 24 h postpartum with generalised pustular psoriasis (von Zumbusch psoriasis). (B) Detail—the pustules are sterile and amicrobial, formed through an immune mechanism.
Figure 3
Figure 3
Psoriatic nail dystrophy.
See this image and copyright information in PMC

References

    1. Griffiths C.E., Barker J.N. Pathogenesis and clinical features of psoriasis. Lancet. 2007;370:263–271. doi: 10.1016/S0140-6736(07)61128-3. - DOI - PubMed
    1. Gottlieb A.B., Ryan C., Murase J.E. Clinical considerations for the management of psoriasis in women. Int. J. Womens Dermatol. 2019;5:141–150. doi: 10.1016/j.ijwd.2019.04.021. - DOI - PMC - PubMed
    1. Tauscher A.E., Fleischer A.B., Jr., Phelps K.C., Feldman S.R. Psoriasis and pregnancy. J. Cutan. Med. Surg. 2002;6:561–570. doi: 10.1177/120347540200600608. - DOI - PubMed
    1. Cohen-Barak E., Nachum Z., Rozenman D., Ziv M. Pregnancy outcomes in women with moderate-to-severe psoriasis. J. Eur. Acad. Dermatol. Venereol. 2011;25:1041–1047. doi: 10.1111/j.1468-3083.2010.03917.x. - DOI - PubMed
    1. Bröms G., Haerskjold A., Granath F., Kieler H., Pedersen L., Berglind I.A. Effect of Maternal Psoriasis on Pregnancy and Birth Outcomes: A Population-based Cohort Study from Denmark and Sweden. Acta Derm. Venereol. 2018;98:728–734. doi: 10.2340/00015555-2923. - DOI - PubMed