Benign and Pathological Cutaneous Manifestations During Pregnancy: A Review of the Literature.

Abstract

Introduction: Pregnancy produces physiological skin changes and a group of specific dermatoses with varying maternal fetal impact. Distinguishing them prevents unnecessary interventions and guides safe therapies. Objective: To identify benign and pathological cutaneous manifestations of pregnancy, their diagnostic criteria, and management from a dermatology obstetrics perspective. Methods: Narrative state-of-the-art review in PubMed/MEDLINE and allied academic sources; inclusion of English/Spanish articles (2015–2025) on physiologic changes, gestational dermatoses, diagnosis, and treatment; exclusion of small series/single case reports. Eighteen publications were selected. Findings: Benign changes such as hyperpigmentation, melasma, striae, telangiectasias, and telogen effluvium are self-limited, and care prioritizes photoprotection and safe topical measures. Among specific dermatoses, atopic eruption/prurigo and PUPPP generally have favorable fetal outcomes; pemphigoid gestationis and intrahepatic cholestasis require confirmation (DIF/anti-BP180; bile acids) and obstetric surveillance. Conclusion: Physiologic patterns predominate; higher-risk entities require timely diagnosis and coordinated management. Emollients, low-to-medium potency topical corticosteroids, second-generation antihistamines, selective NB-UVB, and photoprotection are recommended; higher-risk drugs/procedures are deferred to the postpartum period. Gaps persist in classification, severity scales, and biochemical thresholds.