Pregnancy-specific dermatoses for the resident physician

Pregnancy is associated with a wide range of cutaneous changes. Some are physiological and triggered by normal hormonal fluctuations during pregnancy. There is also a small number of pathological pruritic eruptions that exclusively occur during pregnancy known as pregnancy-specific dermatoses (PSD). In patients presenting with a PSD, features often include severe pruritus and characteristic inflammatory skin changes differing in onset, morphology and configuration. This article gives an overview of benign dermatological changes during pregnancy and the most important presentations of PSDs in order of prevalence: atopic eruption of pregnancy, polymorphic eruption of pregnancy, pemphigoid gestationis and pustular psoriasis of pregnancy. Importantly, we outline how a resident physician can identify these disorders, how to initiate management and when a speciality referral for further investigations and monitoring of the mother and unborn foetus is warranted.