Treating Psoriasis During Pregnancy: Safety and Efficacy of Treatments

Am J Clin Dermatol. 2015 Oct;16(5):389-98. doi: 10.1007/s40257-015-0137-5.

Abstract

Psoriasis is a chronic inflammatory disease with a well-documented negative effect on the quality of life of affected patients. Psoriasis often occurs in the reproductive years, during which the issue of pregnancy needs to be addressed. The course of psoriasis during pregnancy is unpredictable, and many patients face the challenge of needing treatment during pregnancy. In this review we provide an overview of the key considerations for managing psoriasis in pregnant women, covering the potential effects of active psoriasis and co-morbid conditions on the health of the mother and fetus, as well as the effects of psoriasis treatment options on the developing fetus. Although there are no robust data on the safety of systemic treatment of pregnant women, increasing evidence regarding the safety of cyclosporine (ciclosporin) treatment as well as anti-tumor necrosis factor-α is available and should be considered in pregnant women with moderate to severe psoriasis unresponsive to local corticosteroids and UVB light treatment.

Publication types

  • Review

MeSH terms

  • Acitretin
  • Administration, Cutaneous
  • Adrenal Cortex Hormones / administration & dosage
  • Calcineurin Inhibitors / therapeutic use
  • Calcitriol / analogs & derivatives
  • Calcitriol / therapeutic use
  • Coal Tar / therapeutic use
  • Contraindications
  • Cyclosporine / therapeutic use
  • Dermatologic Agents / therapeutic use
  • Female
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Methotrexate
  • Nicotinic Acids
  • PUVA Therapy / adverse effects
  • Pregnancy
  • Pregnancy Complications / therapy*
  • Psoriasis / therapy*
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors
  • Ultraviolet Therapy
  • Ustekinumab / therapeutic use

Substances

  • Adrenal Cortex Hormones
  • Calcineurin Inhibitors
  • Dermatologic Agents
  • Immunosuppressive Agents
  • Nicotinic Acids
  • Tumor Necrosis Factor-alpha
  • calcipotriene
  • Coal Tar
  • tazarotene
  • Cyclosporine
  • Ustekinumab
  • Calcitriol
  • Acitretin
  • Methotrexate