Abstract
Background Since the landmark study on rheumatoid arthritis, many reports have suggested that physiological changes during pregnancy often induce remission of systemic and cutaneous inflammatory diseases. In this study we investigated the clinical course of psoriasis during pregnancy.
Objective In this retrospective study information was collected from Psoriasis Life History Questionnaires. The data obtained from 736 questionnaires were entered into a computerized database. Information relevant to the clinical course of psoriasis during pregnancy was evaluated in respect to improvement/worsening, number of pregnancies, severity of the disease, and certain other clinical parameters.
Results In a majority of the patients psoriasis improved during pregnancy. Data available from 91 pregnancies revealed: psoriasis improved in 51 (56%), worsened in 24 (26.4%), and remained unchanged in 16 (17.6%). Also, appearance of psoriasis new lesions was found to be frequent during the early postpartum period. Patients who improved in the first pregnancy were found to have a similar response in the following pregnancies.
Conclusion Research on immunoโendocrine interactions during pregnancy is a relatively new field. Proinflammatory Thโ1 cytokines are upโregulated in psoriasis and play a key role in the inflammatory cascades of psoriasis. It is likely that during pregnancy the Thโ2 cytokineโmediated downโregulation of the immune response by virtue of its antiโinflammatory and antagonizing effects on the Thโ1 cytokines improves psoriasis.