Atopic eruption of pregnancy

Atopic eruption of pregnancy is an umbrella term for atopic dermatitis, prurigo of pregnancy and pruritic folliculitis of pregnancy. It is the most frequent skin disorder in pregnancy, causing nearly 50% of pregnancy-induced rashes. Twenty percent of patients have a history of atopic dermatitis—the remainder have an atopic background (eg history of asthma, hayfever, food allergy or urticaria), but develop skin lesions for the first time in pregnancy.

Atopic eruption of pregnancy can flare at any stage of pregnancy (most cases present before the third trimester), and varies in presentation from typical flexural dermatitis to follicular and nonfollicular papules and prurigo lesions (excoriated papules and nodules). See here for a photo of atopic eruption of pregnancy.

Figure 1. Atopic eruption of pregnancy

Note:

Reproduced with permission from the A-Z of Skin [digital]. Australasian College of Dermatologists. Sydney. https://www.dermcoll.edu.au/

Atopic eruption of pregnancy can be treated with emollients, antihistamines Bechtel, 2018 (dose recommendations as for polymorphic eruption of pregnancy) and topical corticosteroids.

For dermatitis on the face and flexures, or mild dermatitis elsewhere, use:

hydrocortisone 1% cream or ointment topically, once to twice daily until the skin is clear. hydrocortisone hydrocortisone hydrocortisone

For more severe dermatitis on sites other than the face and flexures, use:

betamethasone dipropionate 0.05% cream or ointment topically, once to twice daily until the skin is clear. betamethasone dipropionate betamethasone dipropionate betamethasone dipropionate

In severe or unresponsive cases, assess for secondary infection, and refer to a dermatologist for consideration of phototherapyMurase, 2014 or oral corticosteroids.