Treatment of dermatologic connective tissue disease and autoimmune blistering disorders in pregnancy.
Autoimmune skin disease occurs in pregnancy, and treatment is often required to control both maternal disease and fetal outcomes. Here we present the available safety data in pregnancy and lactation for medications used to treat autoimmune skin diseases, including cutaneous lupus erythematosus, dermatomyositis, morphea and systemic sclerosis, pemphigus vulgaris, pemphigus foliaceus, and pemphigoid gestationis. A PubMed search of the English-language literature using keywords, "pregnancy" "rheumatic disease," and "connective tissue disease" was performed. Relevant articles found in the search and references were included. Reasonable evidence supports the careful and cautious use of topical steroids, topical calcineurin inhibitors, systemic corticosteroids, hydroxychloroquine, and azathioprine in pregnancy. Case reports or clinical experience suggest intravenous immunoglobulin, dapsone, phototherapy, rituximab, and plasmapheresis may be safe. Several treatment options exist for autoimmune skin disease in pregnancy and lactation, and should be considered when treating these patients.
['Braunstein|Inbal|I|', 'Werth|Victoria|V|']
D000305:Adrenal Cortex Hormones D001327:Autoimmune Diseases D001379:Azathioprine D001768:Blister D065095:Calcineurin Inhibitors D003240:Connective Tissue Diseases D005260:Female D006801:Humans D006886:Hydroxychloroquine D010789:Phototherapy D011247:Pregnancy D011248:Pregnancy Complications D012871:Skin Diseases
blistering disorders pregnancy autoimmune skin disease lactation cutaneous lupus erythematosus dermatomyositis morphea pemphigus vulgaris pemphigus foliaceus pemphigoid gestationis blistering disease rheumatic skin disease