ABSTRACT
Acne is one of the most common dermatological conditions to affect women of childbearing age, so it is important to consider the safety of long-term acne treatments on women who could become pregnant. In this review article, we clarify what management options are available to treat acne during pregnancy. Topical treatments, typically first-line for acne, such as azelaic acid, clindamycin, erythromycin, metronidazole, benzoyl peroxide, salicylic acid, dapsone, and retinoids, were reviewed. Systemic treatments, such as zinc supplements, cephalexin, cefadroxil, amoxicillin, azithromycin, erythromycin, and corticosteroids, typically second-line for acne, were also reviewed. Alternative treatments such as light therapy and cosmetic procedures were also evaluated. Due to recommendation of sunscreen utilization during acne treatments, sunscreen usage during pregnancy was also assessed. Management of acne during unplanned pregnancy was discussed in further detail regarding safety and adverse effects. Through summarized tables and examples of studies demonstrating safety and efficacy of treatments, the following is a resource for providers and patients to utilize for management of acne during pregnancy.
Subject(s)
Acne Vulgaris , Dermatologic Agents , Pregnancy Complications , Humans , Acne Vulgaris/drug therapy , Acne Vulgaris/therapy , Pregnancy , Female , Dermatologic Agents/therapeutic use , Dermatologic Agents/administration & dosage , Dermatologic Agents/adverse effects , Pregnancy Complications/therapy , Pregnancy Complications/drug therapy , Anti-Bacterial Agents/therapeutic use , Anti-Bacterial Agents/administration & dosage , Anti-Bacterial Agents/adverse effects , Sunscreening Agents/administration & dosage , Pregnancy, Unplanned , Phototherapy/methods , Administration, CutaneousABSTRACT
Scleroderma is a rare autoimmune connective tissue disorder characterized by fibrotic hardening and tightening of the skin. Scleroderma develops as a drug-induced and paraneoplastic phenomenon; however, scleroderma associated with COVID-19 has been rarely discussed. We present an updated review of scleroderma after the COVID-19 infection and vaccination. Literature searches were conducted on MEDLINE (PubMed), Embase, Scopus, and Google Scholar from 2019 to January 2023. In all, 13 studies were selected based on the subject relevance, with screening of references contained in the selected papers. As of January 2023, we had four patients with scleroderma after the COVID-19 infection (Mage = 54.50 years; Rage = 47-61 years; man-woman ratio = 1:3) and 10 patients with scleroderma after the COVID-19 vaccination (Mage = 62.8 years; Rage = 45-73 years; man-woman ratio = 1:9). Moderna's Spikevax accounted for two patients, Pfizer-BioNTech's Tozinameran accounted for seven patients, and Oxford-Astra Zeneca's Vaxzevria accounted for one patient. Hypotheses for the pathogenesis of scleroderma after the COVID-19 infection and vaccination included molecular mimicry, cytokine activation, and endothelial injury. Although the benefits of the COVID-19 vaccines still outweigh the risks, we advise clinicians to monitor for this rare potential complication.
