Department of Dermatology, Germans Trias i Pujol University Hospital, Autonomous University of Barcelona, Germans Trias i Pujol Research Institute (IGTP), Badalona, Barcelona, Spain.
Am J Clin Dermatol. 2024 Jan;25(1):55-66. doi: 10.1007/s40257-023-00821-4. Epub 2023 Oct 30.
Hormonal and immunologic changes during pregnancy can contribute to the development of different dermatoses, the most common of which is atopic eruption of pregnancy (AEP). Of atopic dermatitis (AD) cases during pregnancy, 80% are new-onset presentations, while 20% represent recurrences or exacerbations of preexisting disease. Evidence on the effects of previous AD on fertility is limited. Different factors influence women's desire to conceive in this setting, and it has been hypothesized that barrier defects and systemic inflammation could contribute to biologic infertility, although more data are needed. Clinical practice suggests a tendency toward undertreatment in pregnant woman due to concerns about potential effects on obstetric and fetal outcomes. However, pregnant women should be offered adequate and safe treatments, preferably on an individual basis. The aim of this review was to summarize the evidence on disease course in pregnant women with AD and the challenges associated with its diagnosis and management. We also review the current evidence on the use of conventional and novel systemic therapies for AD in this population.
怀孕期间的激素和免疫变化可能导致不同的皮肤病发生，其中最常见的是妊娠特应性皮炎（AEP）。在妊娠期间发生的特应性皮炎（AD）病例中，80%为新发病例，而 20%为原有疾病的复发或加重。关于既往 AD 对生育力影响的证据有限。不同的因素影响着女性在这种情况下的生育意愿，有人假设屏障缺陷和全身炎症可能导致生物不孕，尽管还需要更多的数据。临床实践表明，由于担心对产科和胎儿结局的潜在影响，孕妇的治疗倾向不足。然而，应该为孕妇提供充分和安全的治疗，最好是根据个人情况。本综述的目的是总结 AD 孕妇的疾病过程以及与诊断和管理相关的挑战的证据。我们还回顾了目前关于在该人群中使用传统和新型全身治疗 AD 的证据。
