Pregnancy Complications Associated With Pityriasis Rosea Journal of the American Academy of Dermatology

TAKE-HOME MESSAGE

• In this retrospective review of 33 patients who developed pityriasis rosea while pregnant, birth complications were noted in 8 (24%). However, complications were relatively minor, with no fetal deaths, abortions, or miscarriages. Women with birth complications had an average onset of pityriasis rosea of 10.75 weeks compared with 15.21 weeks in those without complications.

• Pregnant patients with pityriasis rosea, and their obstetricians, should be informed about the slight increase in birth complications associated with the dermatosis.

– Margaret Hammond, MD

Written by

 

 

Kelly H. Tyler MD, FACOG, FAAD

Certain viruses strike fear in the hearts of obstetricians everywhere…parvovirus, rubella, measles. HHV-6/7? Not historically on the list. 

During my ob/gyn training, we studied numerous infectious diseases that could result in catastrophic pregnancy outcomes, but HHV-6/7 or pityriasis rosea (PR) was not among the major offenders, and I never knowingly encountered a PR-related pregnancy complication in general ob/gyn practice. I was surprised to learn of the study by Drago et al in 2018 showing an alarming number of adverse pregnancy outcomes in mothers with PR, particularly those infected before 15 weeks and with high viral loads of HHV-6.

This latest multicenter retrospective study by Stashower et al reassures us that, at least in the patient population studied, PR does not seem to increase the rate of birth complications. That being said, HHV-6 viral loads were not included in this latest study, so more studies are needed to determine if high viral loads increase the complication risk. 

When faced with conflicting studies, I tend to take a more conservative approach with my pregnant patients. If I had a case of mild PR in a pregnant patient, I would feel comfortable reassuring her based on this more recent study. In a severe or more widespread case, I would work with her obstetrician and may consider checking the HHV-6 viral load and initiating more stringent pregnancy surveillance in consultation with a maternal fetal medicine specialist.

Abstract 

Pityriasis rosea (PR) is a common, self-limited, papulosquamous skin eruption associated with human herpesvirus (HHV) -6/7 reactivation, which may occur spontaneously or secondary to certain drugs and vaccines.1 Though generally considered benign, PR may be associated with an increased risk of birth complications if acquired during pregnancy. Increased rates of miscarriage, neonatal hypotonia, and overall birth complications were noted in a recent study of women who developed PR during pregnancy.2 Our study sought to further assess pregnancy outcomes in these patients.

Journal of the American Academy of Dermatology

Pregnancy Complications Associated With Pityriasis Rosea: A Multicenter Retrospective Study

J Am Acad Dermatol 2021 Jan 07;[EPub Ahead of Print], J Stashower, K Bruch, A Mosby, JA Varghese, SM Rangel, RT Brodell, L Zheng, RH Flowers 

Sent from my iPhone

Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

Please excuse the shortness of this message, as it has been sent from
a mobile device.