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Biomedical subjects

Jean-Luc Schmutz

Publications and source records attributed to Jean-Luc Schmutz.

7 recordsLinked to original sources
PubMed2003

[Physiological skin changes during pregnancy].

A NATURAL PHENOMENON: Pregnancy is a period of hormone, immunological, metabolic and vascular changes. Modifications of the skin, mucosa and integuments are therefore physiological. The modifications are in pigmentation, but also affect nevi, the connective tissue, vessels and appendices. Modifications in pigmentation exist in more than 9 pregnancies out of 10 in the form of local melanosis. Melasma, also know as the 'pregnancy mask' or chloasma, is fairly rare. These disorders in pigmentation are also observed in black-skinned women. Changes in nevi (darker brown colour, increase in size) occur in around 15% of pregnancies. MODIFICATIONS IN CONNECTIVE TISSUE: Characterised by vergetures, affecting 60 to 90% of women, appear between the 6th and 8th month of pregnancy and for which there is no satisfactory treatment. Vascular modifications are generally proliferative and due to estrogen impregnation that affects the arteriolar and venous systems. Stellar angiomas are present in 50 to 70% of Caucasian women. Bilateral palmar erythema may also be associated with these angiomas. Varicose veins and varicosities of the lower limbs induced by excessive venous pressure are frequent, as well as oedema (salt-water retention, increased capillary permeability). MODIFICATIONS IN THE APPENDICES: These concern the activity of the sweat glands, the size of the sebaceous glands (Montgomery tubercles), the nails and hair growth.

Connective Tissue Diseases↗
PubMed2003

[Dermatological diseases influenced by pregnancy].

Systemic lupus erythematosus Pregnancy can trigger-off or worsen the disease (60% of lupus flares). The renal damage and hypertension are important prognostic factors. Regarding the foetus, there is a 60% risk of prematurity. The risk of neonatal lupus is basically related to the presence of anti-Ro-SSA and anti-La-SSB antibodies and cannot not be foreseen. Multi-disciplinary surveillance is a necessity for any woman suffering from lupus and wishing to become pregnant. Other connective disorders Pregnancy is rare during scleroderma and has no influence on its progression except in the case of renal damage. Regarding dermatopolymyositis, pregnancy, which is rare, might trigger-off or worsen the disease. Bullous diseases Porphyria may be triggered-off or worsened during pregnancy. The various forms of pemphigus may appear or be enhanced by pregnancy. Various affections The influence of sarcoidosis on pregnancy is negligible. Complications are possible in patients exhibiting a type I or IV Ehlers-Danlos syndrome. Pregnancy can enhance the vascular complications of a pseudoxanthoma elasticum. An exacerbation is possible in the case of a type I neurofibromatosis. Progression varies in the case of psoriasis, atypical dermatitis, acne and Behçet's disease. Genital infections are frequent during pregnancy and often represent a risk for the infant (vaginal candidosis, viral condyloma, gonococci, herpes infection). Varicella The risk of severe neonatal varicella is high when the disease appears in the mother just before or after delivery.

Connective Tissue Diseases↗
PubMed2003

[Specific dermatoses of pregnancy].

A heterogenic group The dermatoses specifically associated with pregnancy are generally benign, even if they lead to great discomfort. Some of them require appropriate management because of the risk of maternal or foetal complications. Pruritus of pregnancy Corresponds to intra-hepatic cholestasis of pregnancy, present in 1 to 2% of pregnant women, it may place the foetus at risk of delayed growth, prematurity or even death in utero. Treatment relies on cholestyramine. Pemphigoid gestationis or herpes gestationis This is an autoimmune disease of pregnancy occurring in multiparous women between the 28th and 32nd week of amenorrhoea (once out of 5 times within the first 7 days postpartum). Diagnosis is confirmed by histological examination of a bullous lesion. The disease usually regresses spontaneously after delivery, generally within a period of 1 to 17 months. Relapses, earlier on and more severe than during the initial episode, occur in 50 to 70% of subsequent pregnancies. Treatment is essentially based on corticosteroids: local Class II for the pauci-bullous and/or limited forms and general corticosteroid therapy for the severe forms. Polymorphic dermatitis of pregnancy This regroups various and similar entities described during pregnancy. They start during the third trimester of pregnancy, their clinical aspects are similar, their histology is non specific, the biological explorations are normal, direct immunofluorescence is negative, the progression is favourable for the mother and the child and the pathogenesis is unknown. Impetigo herpetiformis This exceptional dermatosis affects the primiparous woman in 80% of cases and the eruption usually appears during the 3rd trimester of pregnancy, or even after delivery. Relapses are constant during subsequent pregnancies.

Dermatitis↗