摘要
妊娠特应性皮疹(AEP)是妊娠期最常见的炎症性皮肤病,临床表现为湿疹型或痒疹型皮损,多发生于妊娠早中期,严重影响患者生活质量。其发病机制涉及妊娠期Th2免疫优势、表皮屏障功能障碍及遗传易感性等因素。诊断主要依据临床表现、病史及必要的实验室检查,需与其他妊娠相关皮肤病如妊娠性类天疱疮等相鉴别。治疗上强调个体化方案,以安全性为首要原则:外用保湿剂和弱效糖皮质激素为基础治疗,光疗适用于顽固性病例;系统治疗中,环孢素可作为一线免疫抑制剂,而甲氨蝶呤等药物明确禁忌。近年来,JAK抑制剂(如巴瑞替尼)和生物制剂(如度普利尤单抗)在AEP治疗中展现出潜力,但其妊娠期安全性仍需进一步评估。临床决策需权衡疾病控制与胎儿风险,未来需更多真实世界研究数据以优化治疗方案。本文综述了AEP的流行病学特征、诊断标准、发病机制及治疗策略的最新进展。
Atopic eruption of pregnancy(AEP)is the most common inflammatory skin disease during pregnancy,typically presenting with eczematous or pruritic lesions,with onset most frequently occurring in early to mid-pregnancy.AEP significantly impacts patients′quality of life,and its pathogenesis involves Th2 immune dominance during pregnancy,epidermal barrier dysfunction,and genetic susceptibility.Its diagnosis is primarily based on clinical presentation,medical history,and necessary laboratory tests,requiring differentiation from other pregnancy-related dermatoses such as pemphigoid gestationis.Treatment emphasizes an individualized approach,with safety as the primary concern.Basic therapy includes topical emollients and low-potency corticosteroids,while phototherapy is appropriate for refractory cases.In systemic treatment,cyclosporine may serve as a first-line immunosuppressant,whereas methotrexate is explicitly contraindicated.In recent years,JAK inhibitors(e.g.,baricitinib)and biologics(e.g.,dupilumab)have shown potential in AEP treatment,though their safety during pregnancy requires further evaluation.Clinical decision-making must balance disease control with fetal safety,and future research should focus on real-world data to optimize treatment strategies.This review summarizes the latest advances in the epidemiological characteristics,diagnostic criteria,pathogenesis,and therapeutic approaches for AEP.
作者
刘萍
任世菊
曾奇峰
蔡敏
刁庆春
王禹毅
LIU Ping;REN Shiju;ZENG Qifeng;CAI Min;DIAO Qingchun;WANG Yuyi(Shizhu Tujia Autonomous County People′s Hospital,Chongqing 409100,China;Chongqing Banan District Hospital of Traditional Chinese Medicine,Chongqing 401320,China;First Affiliated Hospital of Chongqing University of Traditional Chinese Medicine,Chongqing Hospital of Traditional Chinese Medicine,Chongqing Key Laboratory of Integrated Traditional Chinese and Western Medicine for Skin Diseases,Chongqing Clinical Research Center for Dermatology,Chongqing 400014,China)
出处
《皮肤性病诊疗学杂志》
2025年第5期377-382,共6页
Journal of Diagnosis and Therapy on Dermato-venereology
基金
重庆市皮肤病学临床医学研究中心(CSTC2015yfpt_gcjsyjzx12-14)
重庆市教育委员会科学技术研究项目(KJQN202415120)。
关键词
妊娠特应性皮疹
妊娠
安全性
创新性药物
atopic eruption of pregnancy
pregnancy
safety
innovative drugs
