Management of Psoriasis in Pregnancy

January 10th, 2009 admin Pregnancy 3 Comments

Psoriasis is a chronic disease of the immune system that appears on the skin, usually in the form of thick, red, scaly patches. Women who develop psoriasis often worry about becoming pregnant. They ask themselves if the baby will develop normally. Will they be able to breastfed? Will their psoriasis get worse during pregnancy? Are the treatments safe for the baby?

According to medical science, Psoriasis is not necessarily a barrier to pregnancy, nor does it affect a woman’s ability to have children. Women with psoriasis generally progress through pregnancy and give birth just like anyone else. However, expectant mothers who suffer from psoriasis need special precaution in their treatment and should be aware of the hereditary nature of this condition, the effect of hormonal changes and tips for ease in breastfeeding.

Treatment options
Pregnant women with psoriasis need to be aware that some treatments for psoriasis may harm their babies. There are not many drugs available to treat pregnant women as most anti-psoriatic drugs are toxic for the fetus. The appropriate treatment for psoriasis in a woman who is pregnant, or who plans pregnancy, will depend on the extent and severity of the skin condition.

Topical treatment:
Topical treatments are first line treatments for psoriasis in pregnancy as most of systemic drugs are toxic to fetus. However, medications for external use are not free from side effects as they are absorbed by the body. Some should be completely avoided during pregnancy as they are potentially teratogenic (causes birth defect).

Emollients: Soothing and moisturising creams may be used without incurring any risk.

Vitamin A derivatives for local use should be avoided because of their teratogenic effect.

Vitamin D derivatives can be used in small quantities in very specific areas.

Corticosteroids (Cortisone): Dermatologists sometimes prescribe cortico-steroids in small quantities for use on very limited areas. It can increase the risk of stretch marks, so it should not be applied to certain parts of the body such as the breasts, abdomen and hips.

Exfoliants such as urea and Salicylic acid: These treatments can be used if their application is limited to small areas of the skin.

Systemic treatment:
Systemic treatments are often teratogenic. These risks are very high when medication is taken during the first trimester of pregnancy. Consequently, most orally administered medicines are stopped during pregnancy.

Dr Syeda Ishrat Jahan…

Menstrual Cramps in Teens

December 5th, 2008 admin Teens Health 0

Every month it is the same old story. You feel like someone is stabbing in your lower abdomen and back. There is nausea, vomiting, diarrhoea, headache, irritability while nervousness are also associated. It compels you to spend most of the day curled up in the bed from the first day of your menstrual period. Cramps in your lower abdomen get worse with time and it happens again in next month.

If you are experiencing the condition, you are not alone. Millions of adolescents and teens are living with this painful condition called menstrual cramping or dysmenorrhoea (painful menstruation).

Dysmenorrhoea — a menstrual disorder that is characterised by painful cramps in the lower abdomen, sometimes accompanied by vomiting, diarrhea, dizziness or fainting — affects 20 to 90 percent of adolescent girls in some way and severely impacts another 14 to 42 percent. Many teenagers with severe cramps suffer for years before they seek treatment because they think painful periods are just part of growing up.

But simply nonsteroidal anti-inflammatory drugs and low-dose oral contraceptives can help alleviate debilitating cramps.

Despite an era of sophisticated drugs and diagnostic tests, dysmenorrhoea remains the leading cause of school absences among teenage girls, beating out even the common cold. Only a small percentage of those affected actually seek medical treatment.

Today experts say that the problem is simply a lack of awareness among teenagers, parents, school nurses and even some physicians that dysmenorrhoea is a condition that needs medication attention, rather than just a natural part of growing up.

An estimated 5 to 10 percent of women with severe pain who suffer from what doctors refer to as secondary dysmenorrhea — painful periods that are caused by an underlying medical condition like uterine fibroids, pelvic inflammatory disease (PID) or most commonly endometriosis.

Nonsteroidal anti-inflammatory drugs (NSAID) like ibuprofen and naproxen are more effective. When over-the-counter medications fail, most physicians recommend a low-dose oral contraceptive, which can prevent the production of prostaglandins altogether. But many parents are concerned about putting their daughters on the pill at such a young age and some consider it as a license to have sex. But the pill, which experts say is medically safe, can also work wonders.

Dr Md Rajib Hossain…