treating pregnant women

Topic: Planning, options necessary in treating pregnant women with psoriasis

Pregnancy can cause myriad changes in a woman’s body. For those with psoriasis or psoriatic disease, the good news is that their condition often clears during pregnancy.

However, pregnancy can exacerbate psoriasis symptoms in some, and symptoms may come back full force immediately after giving birth, necessitating an individual approach to treating the disease in each patient.

“Traditionally, we used to be taught 50% of psoriasis patients get better and 50% of psoriasis patients get worse,” Allison Truong, MD, FAAD, a board-certified dermatologist at Cedars-Sinai in Beverly Hills, California, said. “In my experience, sometimes psoriasis patients can flare for part of a trimester or for part of their pregnancy, but then in other parts of the pregnancy, they have no symptoms.”

A 2015 study published in Psoriasis: Targets and Therapy found 56% of patients with psoriasis improved, while 26.4% had worse symptoms and 17.6% experienced no change.

Hormones and Psoriasis

Research into the effect of hormones on psoriasis is lacking; however, estrogen is known to be anti-inflammatory and may account for the decline in symptoms.

“In some patients, the high estrogen state of pregnancy is helpful for psoriasis symptoms because it is anti-inflammatory, but the moment that you deliver your baby, you can have a flareup of your psoriasis because the estrogen drops precipitously,” Truong said.

Patients who had higher levels of estrogen throughout their pregnancy were found to have more of an improvement in their psoriasis, according to Jenny Murase, MD, director of Medical Consultative Dermatology at the Palo Alto Foundation Medical Group, associate clinical professor at UCSF and co-editor-in-chief of the International Journal of Women’s Dermatology.

Topic Discussed: Planning, options necessary in treating pregnant women with psoriasis

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