Distribution of dermatological changes during pregnancy
Today’s report also covers research into rosacea changes during pregnancy, scalp hydration and pH values in hijab-wearing, and more (1,357 words, 6.5 minutes)
The Women in Dermatology e-newsletter is supported without restriction by Galderma Canada
Good morning, and welcome to the Women in Dermatology e-newsletter from Chronicle Companies. We’re pleased to have you join us. This biweekly bulletin will update you on new findings regarding dermatologic issues that affect women and the female dermatologists who care for them. We welcome your feedback and opinions, so let us know if you have any comments, observations, or suggestions. You can email them to us at health@chronicle.org
A study published in the International Journal of Pharmaceutical and Clinical Research (Oct. 2023; 15(7):798-802) notes that several endocrine, immunologic, metabolic, and vascular changes occur during pregnancy, which can also make women prone to changes in the skin. The researchers classified and analyzed these dermatological manifestations, categorizing them into physiological changes, specific dermatoses of pregnancy, and non-specific skin changes.
This cross-sectional study included a total of 550 pregnant women. Most were in their second trimester and pregnant for the first time. The researchers collected and recorded patient data, including age, main skin issues, time of onset, itchiness, vaginal discharge, relevant family history, exacerbating factors, and associated medical or skin disorders.
The results showed that 98% of the participants experienced physiological changes associated with pregnancy, 6.5% presented specific dermatoses of pregnancy, and 40% exhibited non-specific skin changes that couldn’t be exclusively attributed to pregnancy.
The most common physiological changes were linea nigra, areolar hyperpigmentation, stretch marks, non-pitting edema, melasma, small bumps around the nipples, hyperpigmentation, and redness of the vaginal area. The most common specific dermatoses of pregnancy were pruritic urticarial papules and plaques of pregnancy (PUPPP), pruritus gravidarum, and pemphigoid gestationis. Additionally, the most common non-pregnancy-specific skin changes were various dermatoses, candida vaginitis, scabies, and acne.
The authors note that most of the physiological changes that occur during pregnancy are common during this time and do not require treatment. However, specific dermatoses of pregnancy may cause significant stress and concern to pregnant women and should receive immediate medical attention. Healthcare professionals need to distinguish between the two to provide proper care to their patients.
Bottom line
Recognizing and managing gestational dermatological conditions is crucial during pregnancy. This includes differentiating common physiological skin changes from pregnancy-specific dermatoses. It is important for healthcare professionals to offer timely management when necessary.
The development and validation of the Hair Shedding Visual Scale for Asian women
A study published in the Journal of Dermatology aimed to establish and validate the Hair-Shedding Visual Scale for Asian women (HSVS-A) to differentiate between healthy subjects and women with female pattern hair loss and/or telogen effluvium. The researchers found that the HSVS-A is a reliable tool for identifying hair loss in Asian women with various hair types.
The authors created the HSVS-A by gathering naturally shed hair from Asian women with varying hair lengths. They divided each length group into 10 grades based on the number of shed hairs. The hair was then arranged into clumps of consistent diameter and photographed on a single white A4 paper. This two-part diagnostic study included 205 adult Chinese women who were diagnosed with various types of alopecia. In Part One, 187 subjects were asked to wash their hair at least once within 48 hours. Then, they selected a picture that reflected their average hair shedding during shampooing on a second visit. In Part Two, 18 participants washed their hair every other day for seven consecutive sessions, collecting shed hair in zip-lock bags. The researchers recorded HSVS-A scores for the hair in each bag and manually counted the hair strands.
Research published in the Iraqi Journal of Pharmacy assessed the systemic adverse effects of misusing topical clobetasol on Iraqi women. The researchers found that the misuse of topical clobetasol has significant systemic effects, including alterations in vitamin D, interleukin-6, and hormonal levels, as well as hematological changes.
This cross-sectional observational study, conducted between October 2022 and March 2023, included 98 participants divided into three groups: 31 topical clobetasol users, 32 counterfeit cosmetic product users, and a control group. A dermatologist conducted a clinical examination, and blood samples were collected.
Evaluation of scalp hydration and pH values in hijab-wearing and non-hijab-wearing women
A study in the International Journal of Women's Health evaluated scalp hydration and pH values in hijab-wearing and non-hijab-wearing women in Indonesia, focusing on the potential skin barrier impairment due to scalp occlusion caused by wearing a hijab. The researchers found that scalp hydration and pH values in hijab-wearing and non-hijab-wearing women did not differ significantly, indicating that the use of hijab does not have a significant impact on scalp barrier function.
The researchers conducted a cross-sectional comparative analytical study involving 63 subjects, including 33 hijab-wearing and 30 non-hijab-wearing women. Both groups underwent physical examination, and their medical history was recorded.
A study published in the International Journal of Women’s Dermatology explored the impact of pregnancy on rosacea severity. The researchers found that 48.7% of participants reported worsened rosacea during pregnancy, while 33.3% experienced no change in rosacea severity. Additionally, 17.9% reported an improvement in their rosacea symptoms during pregnancy.
This single-centre retrospective survey study included 39 women with rosacea who were surveyed at five different time points: three months before conception, the first, second, and third trimesters, and six weeks postpartum. Rosacea severity was assessed using a patient global assessment scale.
VIDEO: Can a Black person receive laser hair removal?
Virginia-based aesthetic medicine specialist Dr. Degha Fongod discusses laser hair removal, focusing on considerations for people with darker skin tones, particularly those of African and Indian descent.
A case of multiple firm swellings in a middle-aged woman
A case study published in Indian Dermatology Online Journal described a woman in her 50s who developed painless, slow-growing lumps on her neck and feet over two years. A physical examination revealed three well-defined, firm, skin-coloured nodules on the right side of her neck and the medial area of her feet, close to her heels. A punch biopsy of the neck nodule showed a hypocellular dermal tumour that had a spindle-to-stellate shape and was spread out within a large amount of collagen tissue. The woman was diagnosed with collagenous fibroma, also known as desmoplastic fibroblastoma. Though the study does not explicitly mention how the tumours in the described case resolved, the authors note that simple excisions can cure collagenous fibromas. As well, tumours sometimes resolve spontaneously.
Registration is open for the 2023 Indigenous Skin Spectrum Summit
First held in 2021, the Indigenous Skin Spectrum Summit is a special session of the Skin Spectrum Summit addressing specific challenges in treating Canada’s Indigenous community. This year’s virtual meeting will be held on November 25, 2023.
“When you look at earlier stages of melanoma, you can see that the survival rate is much better in White patients, even at lower stages. So, there are real disparities in melanoma survival outcomes between White and Black patients.”
—Dr. Marissa Joseph, a dermatologist based in Toronto, speaking at the 9th annual Skin Spectrum Summit in October, 2023.
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