妊娠期皮肤病课件

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1、Pregnancydermatoses2009.08.11PhysiologicskinchangesinpregnancyDermatosesexacerbatedbypregnancyDermatosesonlyoccurringinpregnancySpecificdermatosesofpregnancyPhysiologicskinchangesinpregnancy妊娠期皮肤的生理变化Hyperpigmentation色素沉着Occursin90%ofpregnantwomenIncreasedmelanocyte-stim

2、ulatinghormoneAccentuationonareolae,genitalskin,andlineaalbaUsuallyregressespostpartumMelasma黄褐斑Occursin70%ofpregnantwomenAlsoseenwithoralcontraceptivetherapyCentrofacial,malar,andmandibularpatternsExcessivemelanininepidermisordermalmacrophagesWorsenswithUVBexposureHirsu

3、tism多毛症Face,limbs,andbackRegresseswithin6monthspostpartumSlowedconversionfromanagentotelogenhairsNailchanges甲改变TransversegroovingBrittlenessDistalonycholysisIncreasedeccrineglandactivity内分泌腺活性增加MiliariaDyshidroticeczemaHyperhidrosisDecreasedapocrineglandactivity大汗腺活动性减少H

4、idradenitissuppurativaalleviatedIncreasedsebaceousglandactivity皮脂腺活动性增加ExacerbationofacnevulgarisMontgomery’stuberclesenlargeStriaedistensae妊娠纹Occurin90%ofpregnantwomenPinkorpurpleatrophiclongitudinalbandsCausedbyincreasedadrenocorticalactivityFadepostpartumtopersistentp

5、aleatrophicbandsVascularchanges血管变化SpiderneviPalmarerythemaNonpittingfacialedemaVenousvaricosities:LegsVasomotorinstabilityDermographismEdemaandhyperemiaofgingivaeDermatosesexacerbatedbypregnancy妊娠期加重的皮肤病Atopiceczema特应性皮炎Maydeteriorateorremitduringpregnancylimbsand/ortru

6、nkandfaceMaypresentforthefirsttimeinpregnancyinpredisposedpersonIrritanthanddermatitisandnippleeczemacommonpostpartumTreatment:topicalcorticosteroids,emollients,UVBPsoriasis银屑病Mostcommontype:chronicplaquepsoriasisDifferentialdiagnosisofpustularvariantfromimpetigoherpetif

7、ormismaybedifficultTopicaltreatment:Dithranol,calcipotriol,tar,andcorticosteroidsareallsafeinpregnancySystemicdrugs:retinoids,methotrexate,andhydroxyureaareallcontraindicatedinpregnancy.Cyclosporineshouldbeusedwithcautionduringpregnancyandbreast-feeding.Acnevulgaris寻常痤疮U

8、rticaria荨麻疹Lichenplanus扁平苔藓Infections感染性皮肤病Viral(herpessimplex,varicellazoster)Bacterial(impetigo,trich