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Pruritus in Pregnancy

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Pruritus in Pregnancy, Pregnancy Related Pruritus, Pruritus gravidarum, Prurigo gravidarum

  • Pathophysiology
  1. Atopic Eruption of Pregnancy is a collection of immunologic-induced Pruritic Conditions
  1. See Atopic Eruption of Pregnancy
  2. Prurigo of Pregnancy (Common)
    1. Onset in second-half of pregnancy
    2. Erythematous Papules and Nodules over extensor arms and Abdomen
    3. Associated with Atopic Dermatitis
  3. Eczema of Pregnancy or Atopic Dermatitis of Pregnancy (common)
    1. Pruritic Eczematous Dermatitis affecting the face, chest and flexor extremity surface
  4. Pruritic Folliculitis of Pregnancy (uncommon)
    1. Prurigo of Pregnancy variant
    2. Pruritus is very mild (not a key feature)
    3. Onset in second half of pregnancy and resolves postpartum
    4. Diffuse erythematous follicular Papules over trunk (Abdomen, chest, back)
    5. Lesions spread to extremities (esp. arms)
  • Differential Diagnosis
  • Pruritus in Pregnancy
  1. See Pruritus Causes
  2. See Contact Dermatitis
  3. Pruritic Urticarial Papules and Plaques of Pregnancy (Polymorphic Eruption of Pregnancy)
    1. Common, intense Pruritus involving Abdomen
    2. May spread to thighs, buttocks, Breasts and arms
  4. Herpes Gestationis or Pemphigoid Gestationis (uncommon)
    1. Autoimmune disorder with Grave's Disease association
    2. Occurs in second-half of pregnancy
    3. Vesicles and bullae form on Abdomen, extremities
  5. Intrahepatic Cholestasis of Pregnancy (Common)
    1. No Jaundice in mild form (Prurigo gravidarum)
    2. Trunk and extremity itching without rash
    3. Occurs in third trimester and resolves with delivery