Dermatological Diseases and Drug Therapy in Pregnancy

Chee Leok Goh (Associate Professor)

University of Singapore and National Skin Centre,
Singapore

Summary

• Skin disorders may be aggravated by pregnancy; there are four identified pregnancy-related dermatological diseases.
  
  
• Topical steroids and, in severe cases, oral antihistamines are the first-line treatments for polymorphic eruption of pregnancy (PEP) and prurigo of pregnancy (PP) the two most common pregnancy-induced dermatoses.
  
  
• Many dermatological disorders allow for deferral of treatment during pregnancy or alternative therapeutic methods.
  
  
• A number of drugs used in dermatology including isotretinoin, methotrexate, trimeprazine, doxepin and indomethacin should be avoided during pregnancy and lactation.
  

Editor's Comment

Physicians should be aware of the clinical presentation of pregnancy-related dermatoses and, more generally, of the risks of treating dermatologic disease in pregnant women. Accordingly, this doctor's guide has been adapted from an article which appeared in Medscape Women's Health (see http://www.medscape.com/Medscape/WomensHealth/journal/1997/v02.n12 /wh4402.goh/wh4402.goh.html) under the auspices of the author.

Trauma in Adolescent Girls Resulting in Genital Manifestations

Neera Agarwal (Professor)
Amita Suneja (Reader)
Kiran Guleria (Senior Lecturer)

Department of Obstetrics and Gynaecology,
University College of Medical Sciences,
Guru Teg Bahadur Hospital,
Delhi, India

Summary

• Sexual abuse is the most common cause of genital injuries in young girls.
  
  
• Female genital mutilation is widely prevalent in Africa and the Middle East, affecting nearly 130 million adolescents.
  
  
• In a suspected case of sexual abuse, a thorough history and examination is imperative.
  
  
• Examination must not undermine the confidence of the adolescent patient.
  
  
• The patency of the urinary tract must be maintained during any kind of surgical repair.

Editor's Comment

Genital injuries in young adolescent girls must be managed promptly and competently so as to eliminate the chances of any physical scarring or long-term psychological sequelae. This paper outlines the aetiology of these traumas in detail, interspersed with erudite case reports.

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