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Atopic Dermatitis in Pregnancy: Current Status and Challenges

Koutroulis, Ioannis MD*; Papoutsis, John PhD; Kroumpouzos, George MD, PhD, FAAD

Obstetrical & Gynecological Survey: October 2011 - Volume 66 - Issue 10 - p 654-663
doi: 10.1097/OGX.0b013e31823a0908

Atopic dermatitis (AD) is the most common pregnancy dermatosis. This evidence-based review article provides an evaluation of AD in gestation. Our literature search revealed 4 epidemiologic studies on AD in pregnancy, and a total of 55 articles that provide the basis for this review. The limitations of epidemiologic studies included herein are critically reviewed. The management of AD in gestation is reviewed with an emphasis on drug safety. Further studies are required to determine whether it is the intrinsic (“nonallergic” or “atopiform dermatitis”) and/or extrinsic (IgE-associated) AD that is affected by pregnancy, and to establish the postpartum prognosis of “new atopic dermatitis” (AD presenting for the first time in pregnancy). A revision of the diagnostic criteria will allow a more accurate confirmation of the prevalence of AD, and especially “new atopic dermatitis,” in pregnancy as well as differentiation of AD from specific dermatoses of pregnancy, such as prurigo and pruritic folliculitis. Addressing the above issues and unraveling the etiopathogenesis of AD in pregnancy will help clarify a suggested overlap with the above specific dermatoses.

Target Audience: Obstetricians & Gynecologists and Family Physicians

Learning Objectives: After the completing the CME activity, physicians should be better able to correctly diagnose and safely treat atopic dermatitis in pregnancy; differentiate atopic dermatitis from other pregnancy dermatoses; and appraise the controversies and challenges in the field.

*Senior Resident, Department of Pediatrics, Flushing Hospital Medical Center, New York, NY; †Professor, School of Health Units and Welfare Administration, TEI of Antikalamos, Messinia, Greece; and ‡Clinical Assistant Professor, Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, RI

Chief Editor's Note: This article is part of a series of continuing education activities in this Journal through which a total of 36 AMA/PRA Category 1 Credits™ can be earned in 2011. Instructions for how CME credits can be earned appear on the last page of the Table of Contents.

The authors, faculty and staff in a position to control the content of this CME activity and their spouses/life partners (if any) have disclosed that they have no financial relationships with, or financial interest in, any commercial organizations pertaining to this educational activity.

Correspondence requests to: George Kroumpouzos, MD, PhD, FAAD, Department of Dermatology, Rhode Island Hospital, APC 10, 593 Eddy Street, APC 10, Providence, RI 02903. E-mail:

© 2011 Lippincott Williams & Wilkins, Inc.