RT Book, Section A1 Usatine, Richard P. A1 Smith, Mindy A. A1 Chumley, Heidi S. A1 Mayeaux, E.J. SR Print(0) ID 57674926 T1 Chapter 74. Skin Findings in Pregnancy T2 The Color Atlas of Family Medicine, 2e YR 2013 FD 2013 PB The McGraw-Hill Companies PP New York, NY SN 978-0-07-176964-8 LK accessmedicine.mhmedical.com/content.aspx?aid=57674926 RD 2024/10/15 AB A 32-year-old G3P2 woman presents with persistent itching in her 31st week of pregnancy. The itching is constant and worse at night. Her pregnancy had been uncomplicated and she has no past history of medical problems. Many excoriations are noted and there are no blisters (Figure 74-1). She has no jaundice or scleral icterus. Her transaminases were greater than 300 and her total bilirubin was elevated at 2.1. Her bile salts were elevated and her hepatitis panel was negative. The ultrasound showed gallstones but no obstruction was seen. A diagnosis of “intrahepatic cholestasis of pregnancy” was made and the patient was treated with oral ursodiol (a bile salt binding agent) and topical 1% hydrocortisone cream. The bile salts and transaminases were decreased and the patient's pruritus improved but did not resolve until after delivery.1