Eczema Pregnancy Treatment — SCE Dermatology MCQ

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ModerateDermatopharmacologyEczema Pregnancy TreatmentSCE Dermatology

A 40-year-old woman with eczema has a flare during pregnancy. What systemic treatment is safest in pregnancy for severe eczema not controlled by topical therapy?

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Correct answer: B — Oral Prednisolone (short courses) or Ciclosporin — both considered acceptable in pregnancy when topical therapy is insufficient

For severe eczema in pregnancy requiring systemic therapy: short courses of oral Prednisolone are the most commonly used option. Ciclosporin is considered acceptable (extensive transplant data showing no increased teratogenicity). Azathioprine may be continued if already established before pregnancy (not started de novo). Methotrexate and Mycophenolate are ABSOLUTELY CONTRAINDICATED (teratogenic). Dupilumab has emerging but limited pregnancy safety data. NB-UVB phototherapy is safe in pregnancy and should be considered before systemic therapy. The decision requires balancing maternal disease severity against fetal risk, ideally with pre-conception planning. BAD prescribing in pregnancy guidelines provide detailed safety information.

Reference: BAD 2018 Prescribing in Pregnancy; BNF