Skin disorder: -Treatment of pre-existing skin disorders, such as eczema or psoriasis, - topical agents should be used with caution in pregnancy (such as steroid creams).

 Many women suffer from physiological pruritus in pregnancy, especially over the abdomen.  -emotional support, and the application of calamine lotion over the affected area, will improve it.

 - pruritus with or without a rash will be a symptom of a more serious condition.  Generalized pruritus should always be referred to a medical practitioner, as it may be a symptom of conditions such as  intrahepatic cholestasis,  liver disease  thyroid disease,  lymphoma  scabies

 Pemphigoid gestationis (herpes gestationis):  -a disease specific to pregnancy  -occurs in the 2nd -trimester  - persists into the postnatal period  -it starts after the birth. It affects 1 in to 1 in pregnancies  etiology: is unknown

 predisposing factors :  -a maternal autoimmune response to paternal antigens  -the influence of pregnancy hormones.

 Clinical presentation :  -not related to the herpes virus.  -generalized itching  - burning sensation,  - an erythematous rash  - over the abdomen, the trunk,and limbs.  -Blisters develop that may become infected and purulent, especially if the woman scratches.

 Diagnosis:  - A skin biopsy may be needed to confirm the diagnosis.  Management :  -Topical or oral steroids.  - The lesions should be kept clean and may be covered to prevent the woman scratching

 - diet high in vitamins  - IOL at the 37th week of pregnancy, may lead to intrauterine growth restriction with placental insufficiency.  -The baby may have a rash when born and will need pediatric examination for any skin lesions.  -healing without scar if no scratch or any infected lesion, this may take some time up to a few years.

 Flare up by :  -Pregnancy.  - during menstruation.  -at ovulation  - when the woman takes an oral contraceptive.  -recurrence in subsequent pregnancies, especially with the same partner.