Atopic dermatitis in pregnancy: current status and challenges

Atopic dermatitis (AD) is the most common pregnancy dermatosis. This evidence-based review article provides an evaluation of AD in gestation. Our literature search revealed 4 epidemiologic studies on AD in pregnancy, and a total of 55 articles that provide the basis for this review. The limitations of epidemiologic studies included herein are critically reviewed. The management of AD in gestation is reviewed with an emphasis on drug safety. Further studies are required to determine whether it is the intrinsic ("nonallergic" or "atopiform dermatitis") and/or extrinsic (IgE-associated) AD that is affected by pregnancy, and to establish the postpartum prognosis of "new atopic dermatitis" (AD presenting for the first time in pregnancy). A revision of the diagnostic criteria will allow a more accurate confirmation of the prevalence of AD, and especially "new atopic dermatitis," in pregnancy as well as differentiation of AD from specific dermatoses of pregnancy, such as prurigo and pruritic folliculitis. Addressing the above issues and unraveling the etiopathogenesis of AD in pregnancy will help clarify a suggested overlap with the above specific dermatoses.