Differential diagnosis of the pruritus in intrahepatic cholestasis of pregnancy and other specific dermatoses of pregnancy

Abstract

Introduction. Pruritus affects up to 20% of pregnant women. Pruritus can be sufficiently severe to affect sleep and quality of life. Although it is commonly caused by dry skin, it can also indicate an underlying condition unique to pregnancy. The specific dermatoses of pregnancy represent a heterogeneous group of pruritic skin diseases that include intrahepatic cholestasis of pregnancy, pemphigoid gestationis, polymorphic eruption of pregnancy and atopic eruption of pregnancy. It is important for physicians to be familiar with these conditions in order to differentiate them for adopting appropriate management of the condition. Aim of the study. This review was undertaken to find the criteria of the differential diagnosis of pruritus in Intrahepatic cholestasis of pregnancy and other specific dermatoses of pregnancy. Materials and methods. To identify relevant articles, NCBI and ScienceDirect databases were searched using the key words: ”pruritus of pregnancy”, “intrahepatic cholestasis of pregnancy”, “dermatoses of pregnancy”. Results. This study concluded that even if pruritus is a common sign for all specific dermatoses of pregnancy, they have some characteristics that make it possible to differentiate them. Were identified clinical criteria (time of onset, skin lesions character, skin lesions site, association with primi-/multiparity, association with a family history) and paraclinical ones ( Laboratory findings, Histopathology, and immunofluorescence). The pruritus of Intrahepatic cholestasis of pregnancy appear in the second or third trimester, it worsens during the night, skin lesions a represented by excoriations, papules secondary to scratching that involve palms and soles followed by rest of the body. Laboratory findings can reveal increased serum bile acids. Conclusions. The differential diagnosis of the Pruritus in intrahepatic cholestasis of pregnancy and in other dermatoses of pregnancy is facilitated by clinical criteria such as time of onset, skin lesions character, skin lesions site, association with primi-/multiparity, association with family history and paraclinical ones: laboratory findings, histopathology, and immunofluorescence).