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Pregnancy is characterized by altered endocrine, metabolic, and immunologic milieus. These dramatic alterations result in multiple cutaneous changes, both physiologic and pathologic. A comprehensive list of physiologic alterations within the skin and appendages is provided in Table 108-1.1–3
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Pigmentary disturbances are the most common of these physiologic changes (see Table 108-1). Hyperpigmentation of the areola, axillae, and genitalia is well documented in pregnancy. Linea nigra refers to the typically reversible darkening of the linea alba, a hypopigmented linear patch extending from the pubis symphysis to the xiphoid process of the sternum (Fig. 108-2). Melasma or chloasma is a related finding comprising irregular, blotchy, facial hyperpigmentation that occurs in up to 70% of pregnant women (see ...