Öz

29 yaşında gebe 10 gündür mevcut olan yaygın döküntü şikâyeti ile polikliniğimize başvurdu. Dermatolojik muayenesinde boyun, gövde üst bölümü, kollar, kalça ve bacak üst kısımlarında yakacık tarzı skuamlı, somon renkli plaklar mevcuttu. Lezyonların birinden deri biyopsisi alındı. Klinik ve histopatolojik bulgularla pitiriyazis rozea tanısı konuldu. Topikal kortikosteroid ve nemlendirici uygulaması ile hastanın lezyonları 5 hafta içinde geriledi. Pitiriyazis rozea (PR) gövdeden başlayan (madalyon plak), kendi kendini sınırlayan, sık görülen akut bir tablodur ve sıklıkla asemptomatiktir. Gebelikte nadir olarak bildirilmiştir. PR, benign bir hastalık olmasına rağmen HHV-6 ve HHV-7 gibi infeksiyöz etyoloji nedeniyle özellikle de gebeliğin ilk haftalarında fetal infeksiyon, prematür doğum ve hatta ölü doğum riskleri nedeniyle dikkate alınmalıdır. Hastamızın gebeliği ve spontan doğumu sorunsuz gerçekleşti. Yenidoğan 3540 g ağırlığında ve termde dünyaya gelip, konjenital anomali veya deri lezyonu gözlenmedi. Gebelikte PR ve sonuçları konusunda daha fazla çalışmaya ihtiyaç bulunmaktadır. Rutin obstetrik kontrollerde deri lezyonları saptandığında mutlaka dermatoloji konsültasyonu istenmelidir.

Anahtar Kelimeler

• pitiriyazis rozea, gebelik, viral hastalık

PITYRIASIS ROSEA IN A PREGNANT WOMAN: IS PITYRIASIS ROSEA IMPORTANT IN PREGNANCY?

Öz

A 29-year-old pregnant woman was admitted to our out-patient clinic with the complaint of generalized eruption for 10 days. On dermatological examination, salmon-colored scaly patches with peripheral collarette scaling were observed localized on the neck, upper trunk, arms, thighs and upper limbs, accompanied with mild itching. Skin biopsy was performed from one of the lesions. According to the clinical and histopathological findings, the diagnosis was performed as pityriasis rosea. Within 5 weeks her lesions were regressed by the topically application of emollients and corticosteroids.Pityriasis rosea (PR) is a common acute, self-limiting skin eruption which typically begins on the trunk (herald patch) and is often asymptomatic. It has been rarely reported in pregnancy. Although PR is a benign disease, the possibility of an infectious etiology, especially HHV-6 and HHV-7, is of particular concern due to the risks of fetal infection, premature delivery and even fetal death, particularly during the first weeks of gestation. Our patient’s pregnancy and spontaneous delivery were uneventful. The newborn with a birth weight of3540 gwas at full term and did not show any congenital anomaly and or skin lesion.More studies are needed to understand PR and its outcomes in pregnancy. It is however advised to concult with a dermatologist, when such symptoms are observed in routine obstetric practice.

Anahtar Kelimeler

• pityriasis rosea, pregnancy, viral disease

Kaynakça

1. Stulber DL, Wolfrey J. Pityriasis rosea. Am Fam Physician. 2004;69:87-91.
2. Gonzalez LM, Allen R, Janniger CK, Schwartz RA. Pityriasis rosea: an important papulosquamous disorder. Int J Dermatol. 2005;44:757-764.
3. Chuh AA. Pityriasis rosea: roles of the dermatology nurse. Dermatol Nurs. 2004;16:130-134. 4. Ermertcan AT, Özgüven A, Ertan P, Bilaç C, Temiz P. Childhood pityriasis rosea inversa without herald patch mimicking cutaneous mastocytosis. Iran J Pediatr. 2010;20:237-241. 5. Harman M, Aytekin S, Akdeniz S, Inalöz HS. An epidemiological study of pityriasis rosea in the eastern anatolia. Eur J Epidemiol. 1998;14:495-497.
4. Drago F, Broccolo F, Zaccaria E, et. al. Rebora A. Pregnancy outcome in patients with pityriasis rosea. J Am Acad Dermatol. 2008;58:578-583.
5. Lemster N, Neumark M, Arieh I. Pityriasis rosea in a woman and her husband-case report and review of the literature. Case Rep Dermatol. 2010;2:135-139.
6. Chuh A, Lee A, Zawar V, Sciallis G, Kempf W. Pityriasis rosea- an update. IndianJDermatol Leprol. 2005;71:311-315.
7. Drago F, Broccolo F, Rebora A. Pityriasis rosea: an update with a critical appraisal of its possible herpesviral etiology. J Am Acad Dermatol. 2009;61:303-318.
8. Drago F, Malaguti F, Ranieri E, Losi E, Rebora A. Human herpes virus-like particles in pityriasis rosea lesions: electron microscopy study. J Cutan Pathol. 2002;29:359- 361.

9. Drago F, Ranieri E, Rebora A. Is pityriasis rosea skin healthier than helthy skin? Arch Dermatol. 2000;136:932- 933.
10. Vag T, Sonkoly E, Karpati S, Kemeny B, Ongradi J. Avidity of antibodies to human herpesvirus 7 suggests primary infection in young adults with pityriasis rosea. J Eur Acad Dermatol Venereol. 2004;18:738-740.
11. Rebora A, Drago F, Broccolo F. Pityriasis rosea and herpesviruses: facts and controversies. Clin Dermatol. 2010;28:497-501.
12. Robert F. HHV6 and HHV7: persistence and vertical transmission. J Pediatr. 2004; 145:432-434.
13. Hall CB. The human herpesviruses and pityriasis rosea: curious 2002;119:779-780. J Invest Dermatol.
14. Gibson CS, Goldwater PN, MacLennan AH, Haan EA, Priest K, Dekker GA. Fetal exposure to herpesviruses may be associated with pregnancy-induced hypertensive disorders and preterm birth in a caucasian population. BJOG. 2008;115:492-500.
15. Drago F, Rebora A. The new herpesviruses: emerging pathogens of dermatological interest. Arch Dermatol. 1999;135:71-75.
16. Peltier MR. Immunology of term and preterm labor. Reprod Biol Endocrinol.2003;1:122.
17. Bianca S, Ingegnosi C. Pityriasis rosea in pregnancy. Reprod Toxicol. 2007;24:277-278.
18. Cruz MJ, Baudrier T, Azevedo F. Atypical pityriasis rosea in a pregnant woman: first report associating local herpes simplex virus 2 reactivation. J Dermatol. 2012;39:490-492.
19. http://edergi.cbu.edu.tr/ojs/index.php/cbusbed isimli
20. yazarın CBU-SBED başlıklı eseri bu Creative Commons Alıntı-Gayriticari
21. lisanslanmıştır. Uluslararası Lisansı ile