Management of psoriasis in pregnancy

doi:10.1136/bmj.39202.518484.80

BMJ 2007;334:1218-1220 (9 June), doi:10.1136/bmj.39202.518484.80

Practice

Pregnancy plus

Management of psoriasis in pregnancy

Sophie Weatherhead, specialist registrar in dermatology¹, Stephen C Robson, professor of fetal medicine², Nick J Reynolds, professor of dermatology¹

¹ Dermatological Sciences, Institute of Cellular Medicine, Medical School, University of Newcastle upon Tyne, Newcastle upon Tyne NE2 4HH, ² Uterine Cell Signalling Group, Institute of Cellular Medicine, Medical School, University of Newcastle upon Tyne

Correspondence to: N J Reynolds N.J.Reynolds@ncl.ac.uk

Many treatments for this chronic skin disease are harmful tothe developing fetus, so careful pre-conception planning andmanagement adjustment are crucial for the pregnant patient

The first 150 words of the full text of this article appear below.

Introduction

Psoriasis is a common skin condition that causes considerablemorbidity and occupational disability.^w1 It has an estimatedlifetime prevalence of 1.5-2.2% in the adult population,¹^w2with three quarters of patients presenting before the age of40.^w3 Incidence is similar for the two sexes, although womengenerally develop the disease earlier than men. The prevalencein pregnant women is unknown but probably reflects that of non-pregnantwomen of child bearing age. The scenario box on this page showsthat balancing treatment of severe psoriasis with the decisionto try to conceive requires forward planning, and there is alwaysa chance that the disease will worsen. Our patient was fortunateto become pregnant so quickly; less fortunate women can havea prolonged and difficult course and must decide how long theywill try to conceive before resuming systemic treatment.

Scenario

A 30 year old woman had had chronic plaque psoriasis sincechildhood. She . . . [Full text of this article]

Methods

Does pregnancy affect psoriasis?

Does psoriasis affect the outcome of pregnancy?

How are patients with psoriasis managed in pregnancy?

How is psoriasis managed postpartum?

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Rapid Responses:

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Management of psoriasis must include psychosocial interventions: Peter Byrne
bmj.com, 13 Jun 2007 [Full text]
Management of psoriasis must include psychosocial interventions- Authors Reply: Sophie C Weatherhead, et al.
bmj.com, 17 Jun 2007 [Full text]
Management of psoriasis must include psychosocial interventions: Peter Byrne
bmj.com, 18 Jun 2007 [Full text]
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bmj.com, 15 Aug 2007 [Full text]
Cytokine profile in psoriasis - authors reply: Sophie C Weatherhead, et al.
bmj.com, 17 Aug 2007 [Full text]