Unilateral Generalized Keratosis Pilaris Following Pregnancy
Keratosis pilaris (KP) is a common inherited disorder characterized by small folliculocentric keratotic papules that may have surrounding erythema, which gives the skin a stippled appearance resembling gooseflesh. The extensor surfaces of the upper arms, thighs, and buttocks commonly are affected, but a generalized presentation may occur. We report the case of a 29-year-old woman with unilateral generalized KP in the second month of her second pregnancy. Both a genetic mutation and pregnancy-induced hormonal changes played possible roles in the development and progress of unilateral generalized KP in this patient.
Practice Points
- Keratosis pilaris (KP) is a common disorder, with a genetic background and hormonal changes playing possible roles in its development. It also may be associated with a number of diseases.
- The skin lesions of KP usually are bilaterally distributed, either in a generalized or localized distribution. Unilateral lesions are rare. The underlying mechanism of unilateral generalized KP remains unknown.
Our patient’s condition was unusual because the generalized lesions were unilaterally distributed and they occurred early in the pregnancy. Some studies have indicated that hormonal influences may play a role in the development of KP.3,8 Our case also demonstrates KP as a condition in which the onset and severity of the disorder may be associated with the hormonal changes in pregnancy. Additionally, it is worth noting that the lesions presented during the patient’s second pregnancy, but there were no lesions reported during her first pregnancy 14 months prior, which was aborted in the third month. We cannot explain this phenomenon and cannot predict if the lesions will recur in future pregnancies.
Conclusion
We suggest that both a genetic mutation and pregnancy-induced hormonal changes played possible roles in the development and progress of unilateral generalized KP in our patient. Follow-up is necessary in these patients and further work needs to be done to reveal the underlying mechanism.
