11/27. An itching and excoriated dermatosis during intrahepatic cholestasis of pregnancy.A 35-year-old woman at 30th gestation week of her second pregnancy presented to our department with a 2-month history of intense and generalized pruritus. She had a spontaneous abortion 1 year earlier. Itching initially presented during nighttime and localized on lower limbs and after became continuous, diffuse, and associated with excoriations due to scratching. The patient was previously treated with oral corticosteroids (25 mg/d) in a gynecological department with temporary response. On our examination, she presented linear excoriations with hemorrhagic crusts localized on the trunk, buttocks, and upper and lower limbs. biopsy specimen from the lesional area of the right buttock submitted for routine histology documented a mild perivascular and interstitial infiltrate of lymphocytes and monocytes with rare eosinophils on superficial dermis. Indirect and direct immunofluorescence (performed on perilesional skin) were negative. Laboratory investigations revealed microcytic anemia (hemoglobin 7.5 g/dL; medium corpuscular volume 61.7 fl), erythrocyte sedimentation rate (21 mm) and serum bile acid levels (18.3 nmol/L; normal values 1.00-8.90) increase. On the basis of clinical, serological, and histological findings, we diagnosed an itching dermatosis during an intrahepatic cholestasis of pregnancy. We treated the patient with ursodeoxycholic acid (600 mg) and topical corticosteroids with gradual resolution of itching. Furthermore, she delivered a healthy boy at 39th gestation week with normal birth weight and normal apgar score.- - - - - - - - - - ranking = 1keywords = pregnancy, gestation (Clic here for more details about this article) |
12/27. Case report: epidural abscess in a parturient with pruritic urticarial papules and plaques of pregnancy (PUPPP).PURPOSE: To describe the risk factors for epidural abscess (EA) formation following epidural analgesia in a parturient with pruritic urticarial papules and plaques of pregnancy (PUPPP). CLINICAL FEATURES: A 33 yr-old gravida 2 nulliparous patient at 36 weeks gestation presented with severe pre-eclampsia, and PUPPP (treated with prednisone). magnesium prophylaxis was started and labour was induced. An epidural catheter was placed at the L(3-4) level using standard aseptic technique. bupivacaine was incrementally injected to achieve a T10 sensory level, and analgesia was maintained using a continuous infusion of 0.0625% bupivacaine with fentanyl. Nine days post-delivery, the patient developed back pain radiating to her right leg, but she was otherwise asymptomatic. She was afebrile; with a slightly tender, non-erythematous, non-draining, 1 cm nodule at the epidural catheter site. Motor and sensory examinations were normal at that time. However, the patient returned 24 hr later and further investigations revealed: WBC 17,800.mm(-3), platelets 486,000.mm(-3), erythrocyte sedimentation rate 50 mm.hr(-1), and c-reactive protein 8.8 mg.dL(-1). The magnetic resonance imaging demonstrated an EA at the L(3-4) level causing minimal cord compression. The patient underwent an emergency decompressive laminectomy. Cultures revealed methicillin-sensitive staphylococcus aureus. Her pain improved, and she was discharged on the third postoperative day with a six-week course of iv ceftriaxone. CONCLUSION: Causative organisms for EAs include coagulase-negative Staphylococci, S. aureus, and Gram-negative bacilli. infection can occur either hematogenously or by direct contamination during catheter placement. risk factors include immunocompromised states and PUPPP, as with the case of this patient.- - - - - - - - - - ranking = 0.82601050932204keywords = pregnancy, gestation (Clic here for more details about this article) |
13/27. Autoimmune progesterone dermatitis.Seven patients had autoimmune progesterone dermatitis. The morphological findings illustrate the polymorphous nature of the disease in which urticaria, erythema multiforme, and dyshidrosiform lesions were seen. recurrence of the eruption five to ten days prior to the menses with spontaneous resolution following the menses was present in all cases. Intradermal skin testing to progesterone was done to confirm the diagnosis. Six of the seven patients has a history of use of artificial progestational hormones prior to the beginning of their eruption. It is postulated that the artificial progesterones may have been the trigger for the development of their autosensitivity. Treatment with conjugated estrogens resulted in remission of the disease in five of the seven cases reported.- - - - - - - - - - ranking = 0.010984236016935keywords = gestation (Clic here for more details about this article) |
14/27. Pruritic urticarial papules and plaques of pregnancy.The authors present a rare case of pruritic urticarial papules and plaques of pregnancy in a 25-year-old caucasian primigravida admitted to our department because of pruritus in the third trimester of gestation. Recommendations for management are discussed.- - - - - - - - - - ranking = 0.82601050932204keywords = pregnancy, gestation (Clic here for more details about this article) |
15/27. Intrahepatic cholestasis of pregnancy and acute fatty liver of pregnancy. An unusual but favorable association?During the 26th week of a first pregnancy, a 25-year-old woman presented with pruritus suggesting an intrahepatic cholestasis of pregnancy. The pruritus, however, persisted despite the premature delivery of a normal newborn at the 35th week. Moreover, aspartate aminotransferase activity increased, reaching a maximum of 38 times normal level on the 17th day after the delivery. Thus, an acute fatty liver of pregnancy was suspected and confirmed by liver biopsy. This patient appeared to have both intrahepatic cholestasis of pregnancy and acute fatty liver of pregnancy, an association not previously reported. It is suggested that intrahepatic cholestasis of pregnancy caused premature delivery, which in turn may have prevented the onset of severe maternal and fetal complications caused by acute fatty liver of pregnancy.- - - - - - - - - - ranking = 2.4450788199153keywords = pregnancy (Clic here for more details about this article) |
16/27. Severe polymorphic eruption of pregnancy occurring in twin pregnancies.We describe three women pregnant with twins who developed severely symptomatic polymorphic eruption of pregnancy. In all of these women oral prednisolone treatment was indicated and administered to two of them with resulting remission. Both these women breast fed their twins and relapsed in the puerperium requiring further systemic steroid therapy. The third woman was cured by early elective delivery. It has not been previously suggested that the severity of polymorphic eruption is related to multiple pregnancy and this possibility is discussed. The safety of oral prednisolone in pregnancy and during lactation is also reviewed.- - - - - - - - - - ranking = 1.1410367826272keywords = pregnancy (Clic here for more details about this article) |
17/27. Pruritic folliculitis of pregnancy.Pruritic folliculitis of pregnancy may appear any time after the fourth month of gestation. This distinct dermatosis is characterized by pruritus and small, follicle-centered, erythematous papules that may be excoriated or may have the appearance of small pustules. Distribution is variable, although all reported cases have included the abdomen. There is an absence of systemic maternal or fetal toxicity, and the condition resolves spontaneously after delivery. The cause of this dermatosis is unknown.- - - - - - - - - - ranking = 0.82601050932204keywords = pregnancy, gestation (Clic here for more details about this article) |
18/27. Pruritic urticarial papules and plaques of pregnancy.We report an intensely pruritic cutaneous eruption that occurs in the third trimester of pregnancy. The clinical manifestations include erythematous urticarial papules and plaques that begin on the abdomen and spread to involve the thighs and occasionally the buttocks and arms. This dermatosis appears to be clinically distinct from previously described pruritic eruptions occurring in pregnancy. biopsy specimens of the lesions show two histological patterns. We propose that this entity be termed "pruritic urticarial papules and plaques of pregnancy (PUPPP)".- - - - - - - - - - ranking = 1.1410367826272keywords = pregnancy (Clic here for more details about this article) |
19/27. Pruritic urticarial papules and plaques of pregnancy. A case report.A 30-year-old woman developed pruritic urticarial papules and plaques of pregnancy (PUPPP). The eruption, characterized by generalized edematous, erythematous plaques and nonexcoriated papules, began in the third trimester of pregnancy and was responsive to oral corticosteroids. While the etiology of PUPPP is unknown and the clinical features (urticarial plaques) sometimes overlap with those of other dermatoses of pregnancy, we regard PUPPP as a distinct entity. Utilization of a broad base of clinicopathologic and laboratory criteria is important in the workup of a patient with an eruption of pregnancy.- - - - - - - - - - ranking = 1.3040420372882keywords = pregnancy (Clic here for more details about this article) |
20/27. Pruritic urticarial papules and plaques of pregnancy. Involvement in mother and infant.A 19-year-old mother had pruritic urticarial papules and plaques of pregnancy. Similar eruptions were found on her newborn son. This recently recognized eruption of pregnancy, characterized by pruritic papules, papulovesicles, and urticarial plaques, has been seen previously only in mothers. The histologic findings are nonspecific and may include spongiosis, a lymphohistiocytic perivascular infiltrate, papillary edema, and occasional eosinophils. This report raises the possibility that infants may be affected.- - - - - - - - - - ranking = 0.97803152796613keywords = pregnancy (Clic here for more details about this article) |
| <- Previous || Next -> |