Management of Pregnancy‑Associated Dermatoses with Evidence‑Based Recommendations

Polymorphic Eruption of Pregnancy (PEP)

Emollients applied liberally and frequently reduce pruritus and skin scaling in PEP, as recommended by the American Academy of Dermatology. 1

Topical corticosteroids are considered safe for use during pregnancy in treating atopic eruption, according to the American Academy of Dermatology. 1

Prednisolone is the first‑line systemic therapy for pemphigoid gestationis because ~90 % is inactivated by the placenta, minimizing fetal exposure; this recommendation is supported by the British Association of Dermatologists. [2][3]4
Betamethasone and dexamethasone should be avoided in pemphigoid gestationis because they cross the placenta more readily, per British Association of Dermatologists guidance. [2][3]
Management of pemphigoid gestationis requires coordinated care among dermatology, obstetrics, and neonatology teams, as advised by the British Association of Dermatologists. [2][4]
Increased fetal surveillance, including monitoring for prematurity and low birthweight, is recommended in pemphigoid gestationis cases, per British Association of Dermatologists. [2][4]
Approximately 45 % of neonates born to mothers with pemphigoid gestationis exhibit transient skin lesions that typically resolve within four weeks, according to British Association of Dermatologists data. [2][4]

Topical corticosteroids are regarded as safe for use during pregnancy, and prednisolone is the preferred systemic corticosteroid when systemic therapy is required, based on guidance from both the American Academy of Dermatology and the British Association of Dermatologists. [1][2]3