University of Arizona College of Medicine- Phoenix, Phoenix, AZ, USA.
Banner- University Medical Center Phoenix, Phoenix, AZ, USA.
J Med Toxicol. 2024 Jul 11;20(3):308-313. doi: 10.1007/s13181-024-01016-x. Epub 2024 Jun 5.
Kava, a substance derived from the Piper methysticum plant, is enjoying a surge in popularity in the United States due to its purported anxiolytic and analgesic effects. Though ichthyosiform dermopathy is a known adverse effect associated with chronic kava exposure in adults, dermopathy in a newborn due to maternal kava use has not yet been described.
This is a case of a 41-year-old woman who was taking a combination kava/kratom product throughout her pregnancy. She developed an ichthyosiform dermopathy that resolved after she stopped using the product postpartum. Her male infant had a neonatal course complicated by both neonatal opioid withdrawal syndrome, attributed to maternal kratom and buprenorphine use, as well as a diffuse ichthyosiform rash similar to descriptions of kava ichthyosiform dermopathy in adults. His neonatal course was complicated by Group B streptococcus and Serratia marscecens bacteremia (treated with antibiotics) and seizures (treated with lorazepam and phenobarbital). His rash resolved completely by day of life 22. At 9-month outpatient follow-up, he had no dermatologic abnormalities or rash recurrence.
Maternal kava use during pregnancy may cause fetal dermopathy presenting as an acquired ichthyosis. More public education is needed about the potential consequences of kava use, particularly during pregnancy.
卡瓦，一种从卡瓦胡椒植物中提取的物质，由于其据称的抗焦虑和镇痛作用，在美国越来越受欢迎。尽管成人慢性卡瓦暴露会导致鱼鱗样皮肤病，但尚未描述因母亲使用卡瓦而导致新生儿出现皮肤病。
这是一位 41 岁女性的病例，她在怀孕期间一直在服用卡瓦/藤黄产品。她出现了鱼鱗样皮肤病，在停止使用该产品后产后得到缓解。她的男婴在新生儿期出现了多种并发症，包括新生儿阿片类药物戒断综合征，这归因于母亲使用藤黄和丁丙诺啡，以及弥漫性鱼鱗样皮疹，类似于成人卡瓦鱼鱗样皮肤病的描述。他的新生儿期还并发了 B 组链球菌和粘质沙雷氏菌菌血症（用抗生素治疗）和癫痫发作（用劳拉西泮和苯巴比妥治疗）。他的皮疹在出生后第 22 天完全消退。在 9 个月的门诊随访中，他没有皮肤异常或皮疹复发。
母亲在怀孕期间使用卡瓦可能会导致胎儿出现皮肤病，表现为获得性鱼鳞病。需要对卡瓦使用的潜在后果进行更多的公众教育，特别是在怀孕期间。
