Atopic Eruption of Pregnancy: A Recent, but Controversial Classification

Introduction: Atopic Eruption of Pregnancy (AEP) has recently been introduced as a new disease complex in a recent reclassification and it is the most common dermatosis of pregnancy. It encompasses Atopic Eczema (AE), Prurigo of Pregnancy (PP) and Pruritic Folliculitis in Pregnancy (PFP). Material and methods: The authors carried out a literature search in Medline using Pub med, investigating what is presently known about the classification, etiopathogenesis, diagnosis, management and prognosis of AEP. Results: AE during pregnancy includes women who already have eczema, but experience an exacerbation of the disease during pregnancy and women with their first manifestation of AE during pregnancy. The biases T cell immunity towards a type 2 T helper response is important for continuation of a normal pregnancy, but worsens the imbalance already present in most atopic patients. About 25% of patients improve and more than 50% experience deterioration during pregnancy. PP has been reported in all trimesters of pregnancy and has been associated with obstetric cholestasis in women with an atopic background. PFP is a rare specific dermatosis of pregnancy that develops usually during the second or third trimesters. Conclusion: Although the concept of AEP is developing rapidly, the notion of AEP enclosing other specific dermatoses of pregnancy remains controversial. It is necessary to clarify through prospective large-scale studies the relationship between PP, PFP and AE.