Prurigo pregnancy

Introduction to pruritus in pregnancy Prurigo is a group of small wheal rashes and chronic herpes-like skin lesions with severe itching. It is usually divided into acute pruritus, chronic pruritus and symptomatic pruritus. The rash is 1 after delivery. It will fade away within the month and the itching will disappear. It can also last for several months or the next pregnancy. Some people think that pruritus is a mild pregnancy papular dermatitis. basic knowledge The proportion of illness: 1% Susceptible population: pregnant women Mode of infection: non-infectious Complications: fetal distress

Pregnancy pruritus

(1) Causes of the disease

The cause of this disease is unclear, but it tends to be more autoimmune diseases. There are data indicating that the skin sensitivity of pregnant women with pruritus is often higher than that of pregnant women without pruritus, and it is not uncommon for people with allergic diseases such as urticaria and asthma to check. Skin scratch test was positive, eosinophils in blood increased significantly, chorionic gonadotropin increased during pregnancy, sensitivity to pregnancy metabolites may be a causative factor; some scholars believe that pregnancy pruritus is a non-exudative variant of pregnancy herpes These are yet to be further confirmed.

(two) pathogenesis

1. Seen by the naked eye

Symmetrical distribution, mung bean size, rounded top slightly flat, solid papules, accompanied by wheals between the papules, scratching the formation of erosion surface and bloody scars, the skin rash subsided after the skin peeled off, local pigmentation or pigment disappeared.

2. Skin tissue pathological changes

No specificity, early papules are mild hyperepithelial layer hyperplasia, focal sponge formation in the epidermis, occasional small vesicle formation and keratosis, mild lymphocytic infiltration around the superficial vascular layer, sometimes visible A small amount of eosinophils and dermal papillary edema, papules with epidermal exfoliation showed partial epidermal loss, overlying sputum containing degenerating inflammatory nuclei. If serial sections were taken, cytological changes centered on hair follicles were observed as sponges. Formed, there is mononuclear cell infiltration at the opening of the hair follicle to the sebaceous gland, and there is also inflammatory cell infiltration around the hair follicle.

Pregnancy pruritus prevention

1. In daily life, care should be taken to prevent insect bites. It is necessary to pay attention to improving the eating condition and correcting dysfunction of the gastrointestinal tract.

2. Eliminate infections in the body and actively treat diseases in the body.

3. Pay attention to improving nutrition and hygiene.

Pregnancy pruritus complications Complications

Severe rash is unfavorable to the fetus, which can lead to stillbirth. There are reports that the stillbirth rate is 2.5%.

Pregnancy pruritus symptoms Common symptoms Itching pregnant women calf itchy expansive atrophic pattern papules pregnant women tickle herpes wheal blush pigment loss blood sputum

Early pregnant women usually do not suffer from pruritus in pregnancy. Clinically, the following two types are often used according to the period of rash:

Early-onset pregnancy pruritus

Because it occurs in the first half of pregnancy, especially when it occurs at the 3rd and 4th months of pregnancy, the papules occur on the extremities of the extremities, the upper part of the trunk, the upper arm and the thigh are symmetrically distributed on both sides, round and large. To the mung bean, the top is slightly flat, starting from white, later dark red, light red or normal skin color, urticaria-like redness around the papules, after a few days or tens of days, the papules can subside, but there may be new papules recurring Because of the intense itching, especially at night, the sputum is covered with yellow suede on the papules, and after the ecdysis is shed, local pigmentation or pigment loss is left.

2. Delayed pregnancy pruritus

Most occur in the last 2 months of pregnancy, especially within 2 weeks before the birth, the rash form is the same as early pregnancy pruritus, but also can be seen herpes and wheal-like rash, resembling erythema multiforme, more rash It first occurs on the old stretch marks (atrophic lines) of the abdominal wall, and then it can quickly spread to the whole body, itching is severe, because of scratching visible scratches, blood stasis and mossy like secondary rash, the disease is 2 to 3 after delivery. Weekly self-resolved, leaving temporary pigmentation.

Pregnancy pruritus examination

Dermatology examination.

Diagnosis and diagnosis of pruritus in pregnancy

diagnosis

According to the characteristics of the mother, the characteristics and period of the rash, and the pathological changes of the skin tissue, there is no difficulty in diagnosis.

Differential diagnosis

The disease must be differentiated from prurtic urticarial papules and plaque of pregnancy. The latter characteristics are: more common in the first pregnant women, 36 weeks after pregnancy, severe itching, skin lesions occur in swelling The pattern, small red papules are 1~2mm in size, and soon merge into larger red patches, which are more common in the abdomen. Later, urticaria and papular rash spread to the buttocks and thighs. The chest and face are rarely affected. Pregnant women are not sick. Affecting the fetus, the rash completely resolves within a few days after delivery. Because the pathological changes of the skin are similar to the pruritus of the pregnancy, it can only be distinguished by the difference in clinical manifestations.

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