妊娠期皮肤病.ppt

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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-stimulatinghormoneA

2、ccentuationonareolae,genitalskin,andlineaalbaUsuallyregressespostpartumMelasma黄褐斑Occursin70%ofpregnantwomenAlsoseenwithoralcontraceptivetherapyCentrofacial,malar,andmandibularpatternsExcessivemelanininepidermisordermalmacrophagesWorsenswithUVBexposureHirsutism多毛症Face,limbs,andbackRegre

3、sseswithin6monthspostpartumSlowedconversionfromanagentotelogenhairsNailchanges甲改变TransversegroovingBrittlenessDistalonycholysisIncreasedeccrineglandactivity内分泌腺活性增加MiliariaDyshidroticeczemaHyperhidrosisDecreasedapocrineglandactivity大汗腺活动性减少HidradenitissuppurativaalleviatedIncreasedseba

4、ceousglandactivity皮脂腺活动性增加ExacerbationofacnevulgarisMontgomery’stuberclesenlargeStriaedistensae妊娠纹Occurin90%ofpregnantwomenPinkorpurpleatrophiclongitudinalbandsCausedbyincreasedadrenocorticalactivityFadepostpartumtopersistentpaleatrophicbandsVascularchanges血管变化SpiderneviPalmarerythemaN

5、onpittingfacialedemaVenousvaricosities:LegsVasomotorinstabilityDermographismEdemaandhyperemiaofgingivaeDermatosesexacerbatedbypregnancy妊娠期加重的皮肤病Atopiceczema特应性皮炎Maydeteriorateorremitduringpregnancylimbsand/ortrunkandfaceMaypresentforthefirsttimeinpregnancyinpredisposedpersonIrritanthan

6、ddermatitisandnippleeczemacommonpostpartumTreatment:topicalcorticosteroids,emollients,UVBPsoriasis银屑病Mostcommontype:chronicplaquepsoriasisDifferentialdiagnosisofpustularvariantfromimpetigoherpetiformismaybedifficultTopicaltreatment:Dithranol,calcipotriol,tar,andcorticosteroidsareallsaf

7、einpregnancySystemicdrugs:retinoids,methotrexate,andhydroxyureaareallcontraindicatedinpregnancy.Cyclosporineshouldbeusedwithcautionduringpregnancyandbreast-feeding.Acnevulgaris寻常痤疮Urticaria荨麻疹Lichenplanus扁平苔藓Infections感染性皮肤病Viral(herpessimplex,varicellazoster)Bacterial(impetigo,trich