Exploring the Relationship between Psoriasis and Pregnancy: A Systematic Literature Review





Pregnancy, Psoriasis, HLA-Cw6, IL-23, Therapy


This systematic literature review examines the relationship between psoriasis and pregnancy to elucidate possible new routes of treatment. Findings from this review help reduce the gap in the literature on the topic as well as educate physicians and pregnant women with psoriasis on how psoriasis may present along the course of pregnancy and thereafter. Searches were primarily conducted in three databases: PubMed, Scopus, and Embase. Articles considered for inclusion in this literature review focused on the presentation of psoriasis during pregnancy. The literature sample obtained consisted of 14 peer-reviewed articles published from 2012-2022. As codes were identified, a master code list was developed. Second cycle coding involved categorizing of the data allowing for codes to combine and emerge as themes. Five themes were identified through categorical analysis: immunology, general sex hormones, estrogen, progesterone, and the HLA-Cw6 allele. Collectively, these findings elucidate the individual nature of psoriasis and identify progesterone as a possible non-teratogenic therapy. Primarily, the presence of the HLA-Cw6 allele in a woman’s genome along with the individual variation of estrogen receptors reinforces the researcher’s recommendation of genetic testing following a psoriasis diagnosis. This genetic testing may allow patients and physicians to best understand what to expect of psoriasis during pregnancy as well as help determine the most efficacious treatment course to follow for therapy.


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Armstrong, A.W., et al., Psoriasis Prevalence in Adults in the United States. JAMA Dermatol. 2021;157(8):940-6. DOI: https://doi.org/10.1001/jamadermatol.2021.2007

Lambert, J.L.W., et al., Practical recommendations for systemic treatment in psoriasis according to age, pregnancy, metabolic syndrome, mental health, psoriasis subtype and treatment history (BETA-PSO: Belgian Evidence-based Treatment Advice in Psoriasis; part 1). J Eur Acad Dermatol Venereol. 2020;34(8):1654-65. DOI: https://doi.org/10.1111/jdv.16684

Simionescu, A.A., B.M. Danciu, and A.M.A. Stanescu, State-of-the-art review of pregnancy-related psoriasis. Medicina (Lithuania). 2021;57(8). DOI: https://doi.org/10.3390/medicina57080804

Mervic, L., Management of moderate to severe plaque psoriasis in pregnancy and lactation in the era of biologics. Acta Dermatovenerol Alp Pannonica Adriat. 2014;23(2):27-31. DOI: https://doi.org/10.15570/actaapa.2014.7

Parisi, R., et al., National, regional, and worldwide epidemiology of psoriasis: systematic analysis and modelling study. Bmj. 2020;369:m1590. DOI: https://doi.org/10.1136/bmj.m1590

Gratton, R., et al., Unraveling the Role of Sex Hormones on Keratinocyte Functions in Human Inflammatory Skin Diseases. Int J Mol Sci. 2022;23(6). DOI: https://doi.org/10.3390/ijms23063132

Hoffman, M.B., M. Farhangian, and S.R. Feldman, Psoriasis during pregnancy: characteristics and important management recommendations. Expert Rev Clin Immunol. 2015;11(6):709-20. DOI: https://doi.org/10.1586/1744666X.2015.1037742

Danesh, M. and J.E. Murase, The immunologic effects of estrogen on psoriasis: A comprehensive review. Int J Womens Dermatol. 2015;1(2):104-7. DOI: https://doi.org/10.1016/j.ijwd.2015.03.001

Vena, G.A., et al., Psoriasis in pregnancy: challenges and solutions. Psoriasis (Auckl). 2015;5:83-95. DOI: https://doi.org/10.2147/PTT.S82975

Boote, D.N.B., Penny, Scholars Before Researchers: On the Centrality of the Dissertation Literature Review in Research Preparation. 2005;34. DOI: https://doi.org/10.3102/0013189X034006003

Saldaña, J., The coding manual for qualitative researchers. 3rd ed. 2016: Sage.

Taurog, J.D., L.S. Gensler, and N. Haroon, Spondyloarthritis, in Harrison's Principles of Internal Medicine 21e, J. Loscalzo, et al., Editors. 2022, McGraw-Hill Education: New York, NY.

Sobolev, V., et al., Differential Expression of Estrogen-Responsive Genes in Women with Psoriasis. J Pers Med. 2021;11(9). DOI: https://doi.org/10.3390/jpm11090925

Tuğrul Ayanoğlu, B., et al., Diminished ovarian reserve in patients with psoriasis. Taiwan J Obstet Gynecol. 2018;57(2):227-30. DOI: https://doi.org/10.1016/j.tjog.2018.02.010

Lin, X. and T. Huang, Impact of pregnancy and oestrogen on psoriasis and potential therapeutic use of selective oestrogen receptor modulators for psoriasis. J Eur Acad Dermatol Venereol. 2016;30(7):1085-91. DOI: https://doi.org/10.1111/jdv.13661

Hellberg, S., et al., Progesterone Dampens Immune Responses in In Vitro Activated CD4(+) T Cells and Affects Genes Associated With Autoimmune Diseases That Improve During Pregnancy. Front Immunol. 2021;12:672168. DOI: https://doi.org/10.3389/fimmu.2021.672168

Adachi, A., et al., Estradiol suppresses psoriatic inflammation in mice by regulating neutrophil and macrophage functions. J Allergy Clin Immunol, 2022. DOI: https://doi.org/10.1016/j.jaci.2022.03.028

Cemil, B.C., et al., Sex hormones in male psoriasis patients and their correlation with the Psoriasis Area and Severity Index. J Dermatol. 2015;42(5):500-3. DOI: https://doi.org/10.1111/1346-8138.12803

Iwano, R., et al., Estrogen receptor α activation aggravates imiquimod-induced psoriasis-like dermatitis in mice by enhancing dendritic cell interleukin-23 secretion. J Appl Toxicol. 2020;40(10):1353-61. DOI: https://doi.org/10.1002/jat.3988

Chen, L. and T.F. Tsai, HLA-Cw6 and psoriasis. British Journal of Dermatology. 2018;178(4):854-62. DOI: https://doi.org/10.1111/bjd.16083


2023-06-09 — Updated on 2023-06-30

How to Cite

Patra, P. (2023). Exploring the Relationship between Psoriasis and Pregnancy: A Systematic Literature Review. International Journal of Medical Students, 11(2), 128–133. https://doi.org/10.5195/ijms.2023.1714