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[孕期慢性炎症和自身免疫介导的皮肤病。对母亲和孩子的病程及预后]

[Chronic inflammatory and autoimmune mediated dermatoses during pregnancy. Course and prognosis for mother and child].

作者信息

Renner R, Sticherling M

机构信息

Klinik für Dermatologie, Venerologie und Allergologie, Universität Leipzig Anstalt öffentlichen Rechts, Ph.-Rosenthal-Str. 23, 04103, Leipzig.

出版信息

Hautarzt. 2010 Dec;61(12):1021-6. doi: 10.1007/s00105-010-2007-7.

Abstract

Chronic inflammatory dermatoses during pregnancy can take varying courses in mother and child. The dominant Th2-response characteristic for pregnancy may explain why atopic eczema or lupus erythematosus may deteriorate while psoriasis vulgaris may improve. In contrast, impetigo herpetiformis frequently shows a severe course. Lupus erythematosus and other autoantibody-triggered dermatoses like pemphigus vulgaris pose an increased risk for the child because of placental transfer of autoantibodies with specific skin changes or systemic manifestations of the disease as well as placental insufficiency, growth retardation and premature birth. Such risks are not associated with linear IgA dermatosis. A severe pityriasis rosea during the first 20 weeks of pregnancy may lead to an increased risk of abortion or premature delivery. Early diagnosis and individually adjusted therapy of skin diseases is mandatory to avoid any risk for mother or child.

摘要

孕期慢性炎症性皮肤病在母婴身上的病程可能各不相同。孕期典型的Th2反应占主导地位,这或许可以解释为什么特应性皮炎或红斑狼疮可能会恶化,而寻常型银屑病可能会改善。相比之下,疱疹样脓疱病通常病情严重。红斑狼疮以及其他自身抗体引发的皮肤病,如寻常型天疱疮,由于自身抗体通过胎盘转移,会导致胎儿出现特定的皮肤改变或疾病的全身表现,同时还会引发胎盘功能不全、生长发育迟缓及早产,因而对胎儿构成更高的风险。而线状IgA皮病不存在此类风险。孕期前20周出现的严重玫瑰糠疹可能会增加流产或早产的风险。必须尽早诊断并针对皮肤病进行个体化治疗,以避免对母婴造成任何风险。

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