Skin disease in pregnancy.

Skin problems are common during pregnancy, but accurate diagnosis can be difficult. Skin changes in pregnancy can be broadly divided into physiological (box 1), specific dermatoses of pregnancy, and other common skin diseases in pregnancy. In our experience of pregnancy skin clinics, approximately 50% of women present with an exacerbation of a common inflammatory skin disease (for example, eczema, psoriasis, acne, rosacea) or a skin infection. Around 30-50% of women present with one of the specific dermatoses of pregnancy (pemphigoid gestationis, polymorphic eruption of pregnancy, or atopic eruption of pregnancy). Pregnancy causes specific management issues, and there is often confusion over which treatments can be used safely for treating skin disease in pregnancy. Itching can occur in up to 1 in 5 normal pregnancies (physiological pruritus) but is also the presenting symptom of many of the pregnancy dermatoses (box 2). This review aims to familiarise readers with the clinical presentations of common skin diseases in pregnancy, outline the steps for confirming an accurate diagnosis, and evaluate the safest and appropriate treatments. Why is skin disease common in pregnancy?