Pruritic folliculitis of pregnancy

Pruritic folliculitis of pregnancy is a skin condition that occurs in one in 3000 people, about 0.2% of cases, who are in their second to third trimester of pregnancy where the hair follicle becomes inflamed or infected, resulting in a pus filled bump.[1] Some dermatologic conditions aside from pruritic folliculitis during pregnancy include "pruritic urticarial papules and plaques of pregnancy, atopic eruption of pregnancy, pemphigoid gestationis, intrahepatic cholestasis of pregnancy, and pustular psoriasis of pregnancy".[2] This pruritic folliculitis of pregnancy differs from typical pruritic folliculitis; in pregnancy, it is characterized by sterile hair follicles becoming inflamed mainly involving the trunk, contrasting how typical pruritic folliculitis is mainly localized on "the upper back, shoulders, and chest."[3] This condition was first observed after some pregnant individuals showed signs of folliculitis that were different than seen before.[4] The inflammation was thought to be caused by hormonal imbalance, infection from bacteria, fungi, viruses or even an ingrown hair. However, there is no known definitive cause as of yet.[5] These bumps usually begin on the belly and then spread to upper regions of the body as well as the thighs.[6]

This condition does not harm the fetus or the mother and usually resolves after delivery of the baby.[7] The rate of incidence could possibly be higher but due to the unknown etiology of the condition, misdiagnosis, and varying levels of severity, it is difficult to differentiate.[1] Pruritic folliculitis of pregnancy is currently classified as atopic eruption of pregnancy (AEP) in a retrospective study done in 2006 that compared this condition to eczema and prurigo of pregnancy, which occurred in 49.7% and 0.8% of cases respectively, with eczema clearly being more frequent.[8] Unlike typical pruritic folliculitis which does not resolve on its own, pruritic folliculitis of pregnancy clears spontaneously on delivery or in postpartum period.[3][9][4][10] Pruritic folliculitis of pregnancy has no mortality effects or significant adverse effects on the mother or on the fetus.[11][12]

Currently, there are no treatment guidelines for this condition due to the nature of its unknown etiology but symptom relief is strongly emphasized using non-pharmacological interventions such as warm baths or wearing loose clothing.[6] If itchiness and discomfort persists, benzoyl peroxide, low to mid potency topical steroids, or antihistamines can be tried.[6] Novel treatments have also shown potential in treating case studies of pruritic folliculitis of pregnancy, such as using ultraviolet phototherapy. However, further investigation is still required to study its efficacy and safety in second to third trimester pregnant patients.[13]

  1. ^ a b Roth MM (February 2011). "Pregnancy dermatoses: diagnosis, management, and controversies". American Journal of Clinical Dermatology. 12 (1): 25–41. doi:10.2165/11532010-000000000-00000. PMID 21110524. S2CID 5181650.
  2. ^ Cite error: The named reference Lehrhoff_2013 was invoked but never defined (see the help page).
  3. ^ a b Parlak AH, Boran C, Topçuoglu MA (March 2005). "Pityrosporum folliculitis during pregnancy: a possible cause of pruritic folliculitis of pregnancy". Journal of the American Academy of Dermatology. 52 (3 Pt 1): 528–529. doi:10.1016/j.jaad.2004.09.027. PMID 15761438.
  4. ^ a b Cite error: The named reference Zoberman_1981 was invoked but never defined (see the help page).
  5. ^ Cite error: The named reference Ramot_2021 was invoked but never defined (see the help page).
  6. ^ a b c Roth MM, Cristodor P, Kroumpouzos G (2016). "Prurigo, pruritic folliculitis, and atopic eruption of pregnancy: Facts and controversies". Clinics in Dermatology. 34 (3): 392–400. doi:10.1016/j.clindermatol.2016.02.012. PMID 27265078.
  7. ^ Cite error: The named reference Kroumpouzos_2003 was invoked but never defined (see the help page).
  8. ^ Cite error: The named reference Ambros-Rudolph_2006 was invoked but never defined (see the help page).
  9. ^ Vaughan Jones SA, Hern S, Nelson-Piercy C, Seed PT, Black MM (July 1999). "A prospective study of 200 women with dermatoses of pregnancy correlating clinical findings with hormonal and immunopathological profiles". The British Journal of Dermatology. 141 (1): 71–81. doi:10.1046/j.1365-2133.1999.02923.x. PMID 10417518. S2CID 19190726.
  10. ^ Kroumpouzos G, Cohen LM (July 2000). "Pruritic folliculitis of pregnancy". Journal of the American Academy of Dermatology. 43 (1 Pt 1): 132–134. doi:10.1067/mjd.2000.105568. PMID 10863240.
  11. ^ Cite error: The named reference Yakasai_2011 was invoked but never defined (see the help page).
  12. ^ Cite error: The named reference Tunzi_2007 was invoked but never defined (see the help page).
  13. ^ Cite error: The named reference Reed_1999 was invoked but never defined (see the help page).