Folliculitis, pruritic of pregnancy

Author: Prof. Dr. med. Peter Altmeyer

All authors of this article

Last updated on: 29.10.2020

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Synonym(s)

Pregnancy dermatosis; Pruritic folliculitis of pregnancy

History
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Zoberman 1981

Definition
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Intensely itchy pustular pregnancy dermatosis of the last trimester. The disease was first described in 1981 and is still controversial regarding its entity.

Occurrence/Epidemiology
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Incidences are stated as 1 case of illness per 3,000 pregnancies.

Etiopathogenesis
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The cause is unclear. Hormonal imbalances have never been proven. Malassezia furfur was postulated as the trigger, but was rejected in several studies.

Manifestation
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Pruritic folliculitis of pregnancy typically develops in the second half of pregnancy and subsides spontaneously without leaving residuals 2-3 weeks post partum.

Clinical features
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It describes a trunk and upper extremities accentuated, small focal, follicular, violently itchy exanthema, which can become pustular in places.

Histology
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Pustular and non-pustular folliculitis.

Diagnosis
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Typical picture of an exanthema with follicular papules and pustules. The occurrence during pregnancy limits the differential diagnosis. Histology.

General therapy
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First, experiment with bland-free Lotio alba, ethanolic zinc oxide shaking mixture rp. 292, emulsions or gels. Active-ingredient-free cooling gels temporarily relieve itching rp. 039 . Cool showers, cool packs or moist compresses, e.g. with 0.9% NaCL solution, also have a soothing effect. If not sufficient, apply tannin 3-5% in lotio alba or external agents containing menthol or polidocanol (e.g. rp. 158 , rp. 200 , rp. 197 , Optiderm). The next step is glucocorticoid-containing emulsions (e.g. hydrogals, rp. 123 ) or 0.5% hydrocortisone cream (119). Furthermore, narrow band spectrum UVB was successfully applied.

Internal therapy
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The administration of antihistamines during pregnancy is assessed differently in the literature. For severe itching, 1st generation preparations such as clemastine (e.g. Tavegil 2 times/day 1 tbl. p.o. or 2 times/day 1 amp. i.v.) or hydroxyzine (e.g. Atarax 1-3 tbl./day) may be considered.

Progression/forecast
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Some case reports mention developmental disorders (lower birth weight) of the child. This has not been confirmed in other studies.

Literature
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  1. Kroumpouzos G (2005) Pityrosporum folliculitis during pregnancy is not pruritic folliculitis of pregnancy. J Am Acad Dermatol 53:1098-1099
  2. Masood S et al (2012)Frequency and clinical variants of specific dermatoses in third trimester of pregnancy: a study from a tertiary care centre. J Pak Med Assoc 62:244-248
  3. Parlak AH et al (2005) Pityrosporum folliculitis during pregnancy: a possible cause of pruritic folliculitis of pregnancy. J Am Acad Dermatol 52:528-529
  4. Reed J et al (1999) Pruritic folliculitis of pregnancy treated with narrowband (TL-01) ultraviolet B phototherapy. Br J Dermatol 141:177-179
  5. Zoberman E (1981) Pruritic folliculitis of pregnancy. Arch Dermatol 117:20-22.

Outgoing links (2)

Clemastine; Hydroxycin;

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

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Last updated on: 29.10.2020