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Cutaneous Changes Commonly Associated with Pregnancy at a Glance
  • Cutaneous changes result from the altered endocrine, metabolic, and immunologic milieus that characterize pregnancy.
  • Pigmentary disturbances, including hyperpigmentation, darkening of the linea alba, and melasma are the changes most commonly observed.
  • Significant change in nevi size is not a feature of most pregnancies.
  • Structural changes known to occur during pregnancy include, most commonly, striae distensae.
  • Pruritus is a common complaint during pregnancy and may be related to flare of a preexisting dermatosis or onset of a specific dermatosis of pregnancy.

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 108-1.13

Table 108-1 Physiologic Skin Changes during Pregnancy

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 eFig. 108-2.1). This ...

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