Advances in the diagnosis and treatment of atopic eruption in pregnancy

Atopic eruption of pregnancy (AEP) is the most common inflammatory skin disease during pregnancy, typically presenting with eczematous or pruritic lesions, with onset most frequently occurring in early to mid-pregnancy. AEP significantly impacts patients' quality of life, and its pathogenesis involves Th2 immune dominance during pregnancy, epidermal barrier dysfunction, and genetic susceptibility. Its diagnosis is primarily based on clinical presentation, medical history, and necessary laboratory tests, requiring differentiation from other pregnancy-related dermatoses such as pemphigoid gestationis. Treatment emphasizes an individualized approach, with safety as the primary concern. Basic therapy includes topical emollients and low-potency corticosteroids, while phototherapy is appropriate for refractory cases. In systemic treatment, cyclosporine may serve as a first-line immunosuppressant, whereas methotrexate is explicitly contraindicated. In recent years, JAK inhibitors (e.g., baricitinib) and biologics (e.g., dupilumab) have shown potential in AEP treatment, though their safety during pregnancy requires further evaluation. Clinical decision-making must balance disease control with fetal safety, and future research should focus on real-world data to optimize treatment strategies. This review summarizes the latest advances in the epidemiological characteristics, diagnostic criteria, pathogenesis, and therapeutic approaches for AEP.