Please login or create an account. If you do not have access to this content, you will be shown a 30 second preview and licensing options.
- Presentation
Managing Autoimmune & Inflammatory Skin Disorders in Pregnant & Breastfeeding Patients
Description
The session addresses the management of autoimmune and inflammatory skin disorders in pregnant and breastfeeding patients, featuring discussions between Dr. Katarina Shaw, a dermatology expert, and Dr. Nicole Smith, a maternal-fetal medicine specialist. They emphasize the importance of managing skin diseases such as dermatomyositis, lupus, and atopic dermatitis during pregnancy, highlighting how pregnancy can affect disease activity and the implications for treatment. The presenters discuss various medications, including the safety and efficacy of systemic treatments like IVIG, steroids, and biologics, such as dupilumab and rituximab, during pregnancy and lactation. They point out the need to consider the risks of untreated disease against the potential risks of medication exposure, stressing the importance of informed patient choice. The discussion also touches on the broader social context regarding reproductive health and the necessity for clinicians to integrate reproductive planning into care for patients of reproductive age. Overall, the session advocates for a thoughtful and informed approach to treating autoimmune skin disorders in pregnant and breastfeeding individuals, balancing the benefits and risks of treatment options.
View moreConclusions
- Women with autoimmune diseases can have successful pregnancies with appropriate management and treatment.
- Certain medications are safe to use during pregnancy and breastfeeding, as their benefits often outweigh the risks.
- Clinicians should assess the impact of the disease on pregnancy and vice versa, considering medication safety and potential risks to maternal and fetal health.
- Topical steroids and hydroxychloroquine are deemed safe for use during pregnancy.
- Systemic steroids may not have significant teratogenic effects, though caution is recommended in their use.
- There is a need for careful consideration of the risks of untreated autoimmune disease versus the risks associated with medication during pregnancy.
- Newer biologic therapies, such as anifrolumab, show promise in safely managing autoimmune skin diseases in pregnant patients.
- Collaboration between dermatology and maternal-fetal medicine specialists is vital for optimal care of pregnant patients with autoimmune disorders.
- Statistical data indicates that common concerns regarding certain medications may not be substantiated by recent research findings.
- Abu-Raya et al. Maternal Immunological Adaptation During Normal Pregnancy, Frontiers in Immunology, 2022
- Niklas Worm Andersson, MD; Lone Skov, MD, PhD; Jon Trærup Andersen, MD, PhD. Evaluation of Topical Corticosteroid Use in Pregnancy and Risk of Newborns Being Small for Gestational Age and Having Low Birth Weight. JAMA Dermatology. 2021;157(7):788-795. doi:10.1001/jamadermatol.2021.1090
- Bandoli, et al. A review of systemic corticosteroid use in pregnancy and the risk of select pregnancy and birth outcomes. Rheum Dis Clin North Am. 2017 Aug; 43(3): 489-502.
- Murrell DF, et al. Diagnosis and management of pemphigus: Recommendations of an international panel of experts. J Am Acad Dermatol. 2020 Mar;82(3):575-585.e1.
- Patrick McMullan 1, Marita Yaghi 2, Thu M Truong 3, Marti Rothe 1, Jenny Murase 4, Jane M Grant-Kels 5. Safety of dermatologic medications in pregnancy and lactation: An Update. J Am Acad Dermatol. 2024 Jan 25:S0190-9622(24)00109-9.