REVIEW  AUTOIMMUNE CUTANEOUS DISEASES AND PREGNANCY: MANAGEMENT AND TREATMENT 

Giornale Italiano di Dermatologia e Venereologia 2019 June;154(3):305-14

DOI: 10.23736/S0392-0488.18.06255-7

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Moderate-to-severe psoriasis and pregnancy: impact on fertility, pregnancy outcome and treatment perspectives

Clara DE SIMONE ¹ ✉, Giacomo CALDAROLA ¹, Gaia MORETTA ¹, Leonardo PISCITELLI ², Federica RICCERI ², Francesca PRIGNANO ²

¹ Department of Dermatology, A. Gemelli University Hospital and Institute for Research and Cancer, IRCCS, Sacred Heart Catholic University, Rome, Italy; ² Unit of Dermatology, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy

Psoriasis affects 2-4% of the world’s population, with no difference between men and women and 70% of patients experiencing disease onset before the age of 40, which coincides with the reproductive years. Few data are available from literature on impact of psoriasis on fertility, course and outcome of pregnancy and risk associated with treatments. Recent studies on other immune-mediated inflammatory diseases, among which psoriasis is also included, indicate that rheumatoid arthritis and inflammatory bowel diseases can impact female fertility and pregnancy outcomes especially during active disease episodes. In psoriasis hormonal and metabolic comorbidities, unhealthy lifestyles and systemic inflammation could also influence the ability to conceive, pregnancy course and birth outcomes. In this article we review current knowledge on reproductive function, course and outcome of pregnancy in women affected by moderate-to-severe psoriasis. Systemic treatments are also considered with a special focus on TNF-alpha blocking agents and implication of molecular structure on placental transportation and fetal exposure.

KEY WORDS: Fertility; Psoriasis; Autoimmune diseases; Pregnancy complications