Retrospective Analysis of Skin Changes and Dermatoses Observed in Pregnants Applying to the Dermatology Outpatient Clinic

Yıl 2023, Cilt: 20 Sayı: 3, 649 - 656, 31.12.2023

Şule Subaşı Gökşin Işıl Göğem İmren

https://doi.org/10.35440/hutfd.1364998

Öz

Background: Endocrinological, vascular or immunological changes during pregnancy can cause many diffe-rent clinical skin conditions. Objective was to make analysis of skin changes and dermatoses in pregnant patients who applied to the dermatology outpatient clinic.
Materials and Methods: One hundred-twelve pregnant patients who have applied to the dermatology outpatient clinic from March 2021 to September 2022 were included to the study.
Results: The mean age of the patients was 28.8±6.9 (min.18-max.44). 57.2% of the pregnant women were primigravida and 42,8% were multigravida. Pregnant women frequently applied to the outpatient clinic in the 2nd and 3rd trimesters (78.6%). Physiological skin changes were observed in 82.1% of the cases. Stria gravidarum was the most common (51.8%). Chloasma in 9%, varicose veins and spider angioma in 5.4%, linea nigra, acrochordon, cherry angioma and hair loss in 2.7%, hirsutism and ingrown nails in 1.8%, pyo-genic granuloma in 0.9% of the cases were observed. Skin infection was detected in 33.9% of the cases. Fungal infections (Dermatophytosis 9%, pityriasis versicolor 3.6%, candida 1.8%) were most common with 14.3%, scabies was the second most common with 11.6%. Pregnancy-specific dermatoses such as atopic eruption of pregnancy, pemphigoid gestationis and impetigo herpetiformis were seen in 2.7% of the cases. Non-pregnancy-specific dermatological diseases was 27.7%. Among these diseases, seborrheic dermatitis was 9%, psoriazis was 6.2%, acne and rosacea were 3.6%. Physiological changes of pregnancy and preg-nancy-specific dermatoses were significantly higher in the 3rd trimester compared to the first 2 trimesters (p=0.01, p=0.049, respectively) and in primigravidas compared to multigravidas (p=0.01, p=0.043, respec-tively). The recurrent outpatient clinical admissions were significantly higher in multigravidas than in primigravidas (p=0.0007) and in the 3rd trimester compared to the 1st and 2nd trimesters. (p=0.004).
Conclusions: The most common skin disorders during pregnancy are physiological skin changes. Pregnancy specific dermatoses are rare. The most common skin infections in pregnancy are fungal infections. Skin changes and spesific dermatoses increase in the third trimester.

Dermatoloji Polikliniğine Başvuran Gebelerde Gözlenen Deri Değişiklikleri ve Dermatozların Retrospektif Analizi

Öz

Amaç: Gebelikte endokrinolojik, vasküler veya immünolojik değişiklikler deride birçok farklı klinik duruma neden olabilir. Dermatoloji polikliniğine başvuran gebe hastalarda gözlenen deri değişiklikleri ve dermatozların klinik analizini yapmak.
Materyal ve metod: Çalışmaya Mart 2021 ile Eylül 2022 tarihleri arasında dermatoloji polikliniğine başvuran 112 gebe hasta dahil edildi.
Bulgular: Hastaların yaş ortalaması 28,8±6.9 (min.18-max.44) idi. Gebelerin %58'i primigravida, %42'si multigravida idi. Gebeler sıklıkla 2. ve 3. trimesterde polikliniğe başvurdu (78.6%). Olguların %82.1'inde fizyolojik deri değişiklikleri görüldü. En sık stria gravidarum %51.8, kloazma %9, variköz venler ve spider anjiyom %5.4, linea nigra, akrokordon, cherry anjiyom ve saç dökülmesi %2.7, hirsutizm ve tırnak batması %1.8, pyojenik granülom %0.9 olguda görüldü. Olguların %33,9'unda cilt infeksiyonu saptandı. Mantar infeksiyonları (Dermatofitoz %9, pitriyazis versikolor %3.6, kandida %3.6) %14.3 ile en sık, uyuz %11.6 ile ikinci sıklıkta görüldü. Gebeliğin atopik erüpsiyonu, pemfigoid gestasyonis ve impetigo herpetiformis gibi gebeliğe özgü dermatozlar olgularının %2,7'sinde görüldü. Gebeliğe özgü olmayan dermatolojik hastalık oranı %27.7 iken, bu hastalıklar içinde seboreik dermatit %9, psoriazis %6.2 akne ve rozasea ise %3.6 oranındaydı. Primigravidalarda ve üçüncü trimesterde pigment değişiklikleri, stria gravidarum ve gebeliğe özgü dermatozlar istatistiksel olarak anlamlı düzeyde yüksekti (p<0.05). Multigravidalarda ve üçüncü trimesterde tekrarlayan poliklinik başvurularının istatistiksel olarak anlamlı olduğu gözlendi (p<0.05).
Sonuç. Hamilelik sırasında en sık görülen deri değişikliği fizyolojik deri değişiklikleridir. Gebeliğe özgü dermatozlar nadir görülür. Gebelikte en sık görülen deri infeksiyonları mantar infeksiyonlarıdır. Üçüncü trimesterde deri değişiklikleri ve spesifik dermatozlar artar.

Anahtar Kelimeler

gebelik, dermatozlar, cilt değişiklikleri, poliklinik

Etik Beyan

Üniversitenin Klinik Araştırmalar Etik Kurulu'ndan etik izin alındı (Onay numarası ve tarih: E-60116787-020-277707, 27.09.2022).

Kaynakça

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