Redness around the chin during pregnancy

We know that pregnancy is a very important period. If there is any abnormality in the pregnant woman's body, people will worry that it may affect the development of the fetus. Redness around the chin is common in pregnant women. The reason is related to the use of cosmetics. Some cosmetics contain hormones, which lead to glucocorticoid-dependent dermatitis. We can learn about this disease and make judgments based on our own symptoms.

Clinical manifestations

1. Thinning of the epidermis and dermis

Long-term local application of hormones can lead to reduced granule formation in the stratum corneum and thinning of the stratum corneum. The elastic changes in glycoproteins and proteoglycans in the dermis weaken the adhesion between collagen fibrils, reducing collagen synthesis and causing thinning.

2. Hypopigmentation and pigmentation

As the number of stratum corneum layers decreases, less melanin migrates to keratinocytes, causing hypopigmentation. Pigmentation may be related to glucocorticoids activating melanocytes to regenerate pigment.

3. Vascular exposure

The weakening of the adhesion between collagen fibers in the blood vessel wall can lead to widening of the blood vessels, and the disappearance of dermal collagen leads to the exposure of surface blood vessels.

4. Rosacea and acne-like dermatitis

In hormone-induced rosacea-like lesions, the density of Demodex mites in the hair follicles increases significantly. Demodex mites block the exit of the sebaceous glands in the hair follicles, causing inflammatory or allergic reactions. Potent hormones can also cause sebaceous gland hyperplasia, leading to a unique rosacea-like rash. Hormones can cause the hair follicle epithelium to degenerate and become blocked, leading to acne-like rashes or worsening of existing acne.

5. Folliculitis

Due to the immunosuppressive effect of hormones, local hair follicles may become infected and primary folliculitis may worsen.

6. Hormone dependence and rebound phenomenon

The anti-inflammatory properties of hormones can inhibit the development of papules and relieve itching, cause vasoconstriction, and eliminate erythema. However, hormones cannot eliminate the cause of the disease, and discontinuation of use can often cause the original disease to worsen, which can manifest as rebound phenomena such as inflammatory edema, redness, burning sensation, discomfort, and acute pustular rash. This phenomenon often occurs 2 to 10 days after stopping hormones and lasts for several days or about 3 weeks. Due to the rebound phenomenon, patients continue to use topical hormones, which causes hormone dependence.

diagnosis

1. Long-term and repeated use of topical glucocorticoids for more than 1 month, which may improve symptoms during use but recur after stopping the medication.

2. The primary skin disease has been cured, but obvious dermatitis symptoms such as erythema, papules, pustules, loss of skin lines, and desquamation reappear.

3. It often occurs on the face, vulva, wrinkles and other areas with thin and tender skin.

4. Long-term use of the drug may leave symptoms such as pigmentation (hypopigmentation), stretch marks, capillary dilation, hirsutism, pustules, etc., accompanied by tingling and burning sensations.

Differential Diagnosis

The diagnosis can be made based on a history of long-term use of topical hormones or cosmetics containing hormones and the characteristic skin lesions. However, it needs to be differentiated from tinea faciale, acne, rosacea, seborrheic dermatitis, lupus frostbite, and disseminated miliary lupus of the face.