Prurigo pregnancy

Introduction Some pregnant women during pregnancy, especially early pregnancy, will have systemic or localized skin itching, the degree is light and heavy, in severe cases can make people restless, unbearable, this condition is called pregnancy pruritus. It is usually divided into acute pruritus, chronic pruritus and symptomatic pruritus. The rash subsided by itself within 1 month after delivery, and the itching disappeared. It can also last for several months or the next pregnancy. Some people think that pruritus is a mild pregnancy papular dermatitis.

Cause

Cause:

The etiology of this disease is unclear, but it is more prone to autoimmune diseases. It is not uncommon for pregnant women with pruritus to have skin sensitivity that is higher than that of pruritus-free pregnant women and allergic diseases such as urticaria and asthma. Check skin scars. The test was positive, the eosinophils in the blood increased significantly, and the sensitivity of pregnancy chorionic gonadotropin to pregnancy metabolites may be a causative factor; some scholars believe that pregnancy pruritus is a non-exudative variant of gestational herpes. Confirmed.

Pathogenesis:

1. Seen by the naked eye:

Symmetrical distribution, mung bean size, rounded top and slightly flat solid papules. There is a wheal between the papules to form a denuded surface and bloody scars. After the molting, the skin rash subsides, and the local pigmentation or pigment disappears.

2. Skin tissue pathological changes:

No specificity. In the early stage of papules, the epithelial layer is hypertrophic, and focal sclerosis is formed in the epidermis. Occasionally, small blisters are formed and keratinized. Mild lymphocytic infiltration around the superficial blood vessels of the dermis, sometimes with a small amount of eosinophils and dermal papillary edema. The papules with exfoliation of the epidermis are characterized by partial epithelial loss of overlying sputum containing degenerating inflammatory nuclei. If continuous sections are seen, the cytological changes centered on the hair follicles are characterized by the formation of sponges at the opening of the hair follicle to the opening of the sebaceous glands. Monocytes infiltrate around the hair follicles and also have inflammatory cell infiltration.

an examination

Related inspection

Skin lesion

Mainly for pathological biopsy: non-specific lichen-like tissue reaction, epidermal keratosis, epidermal hyperplasia, intercellular edema, basal cell liquefaction, perivascular cell infiltration and vasodilation, pigmentation incontinence were observed. Occasionally, eosinophils in peripheral blood increased.

According to the rash, the erythema is mostly erythema, papules, nodular damage, symmetrical arcing occurs, and the extremities are stretched to the side, especially the upper limbs. The rash is followed by pigmentation patches, with severe itching, chronic disease, and is not difficult to diagnose.

The pathological changes of the disease are non-specific chronic inflammation, hyperkeratosis and parakeratosis of the epidermis, hypertrophy of the spinous cell layer, edema in the epidermis, blisters in the superficial epidermis, mild edema in the dermis, and lymphocytic infiltration around the blood vessels. The pathological epidermis of nodular pruritus has obvious hyperkeratosis and acanthosis, papillary hyperplasia, superficial dermal tissue cells, and lymphocyte infiltration.

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 the onset of severe itching, skin lesions occur in the expansion of red The papules are 1~2mm in size and soon merge into larger red plaques, which are more common in the abdomen. Later, urticaria and papular rash spread to the buttocks and thighs. The chest surface is rarely affected by pregnant women and does not affect the fetus. The rash faded on its own for several days. Because the pathological changes of skin tissue and the pruritus of pregnancy can only be distinguished by the difference in clinical manifestations.

Clinical manifestations:

Early pregnant women usually do not have pregnancy pruritus clinically often divided into the following two types according to the period of rash:

1. Early-onset pregnancy pruritus:

Named after the first half of pregnancy, especially at the 3rd and 4th months of pregnancy. The papules occur in the upper upper arm of the torso of the extremities, and the upper part of the thigh is symmetrically distributed in a circular shape. The miliary size is as large as the top of the mung bean. The white top is slightly reddish or normal skin color. There are urticaria-like blush around the papules. After a few days or tens of days, the papules can regress but new papules can reappear. Because of the itching intense nighttime, especially when the pimples are covered with yellow suede. After the molting is detached, local pigmentation or pigment loss is left.

2. Late-onset pregnancy pruritus:

It occurs more often in the last 2 months of pregnancy, especially within 2 weeks before delivery. The rash morphology is similar to that of early-onset pruritus, and there are also herpes and wheal-like rashes, which resemble erythema multiforme. The rash occurs first on the old stretch marks (atrophic lines) on the abdominal wall and then rapidly spreads throughout the body. Itching is severe, because of scratching visible scratches, blood stasis and mossy changes and other secondary rashes. This disease will resolve spontaneously 2 to 3 weeks after delivery, leaving temporary pigmentation.

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

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.