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Perinatology.com Dermatoses in Pregnancy — Pattern & Photo Tools
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Dermatoses in Pregnancy + Key Infectious Rash Patterns BETA TESTING

Quick pattern recognition + photo checklist + client-side “de-identify” tools to help structure a differential. This page is not diagnostic—use clinical judgment, labs (e.g., bile acids/LFTs when indicated), and dermatology / infectious-disease consult for uncertain or high-risk presentations.

PHI / photo privacy

Avoid uploading identifiable patient photos to consumer visual-search tools. Prefer HIPAA-compliant workflows (EMR media capture, secure eConsult/tele-derm, or contracted platforms).

If you must compare externally for education, de-identify (crop/blur), avoid unique backgrounds, and document consent per your policies.

Photo tools (preview → de-identify → compare)

Preview is local-only. De-ID tools are client-side; external links are optional.

Local preview + De-ID (client-side)

Use this before any upload. Exporting from canvas typically strips EXIF metadata.

No upload
Select a photo to preview here.
Tip: include a scale marker (ruler/coin) and 2–3 views (close + mid + anatomic context).
Selected image preview

The preview does not upload the image. If you export a de-identified copy below, it re-encodes the image. This helps remove embedded metadata but does not guarantee privacy.

De-identify helper (crop + pixelate)

1) Crop away identifiers → 2) Pixelate tattoos/face/jewelry → 3) Export and use the exported copy if needed.

Client-side
Tip: larger brush for faces; smaller for jewelry/tattoos.
Mode: Crop Brush: 35
Reminder: Consumer image tools may store uploads and are not designed for PHI. Prefer HIPAA-compliant workflows for any identifiable patient image.

External compare tools (optional)

Use clinical atlases first; visual-search second (education only).

Opens new tab
“Search builder” (opens a text search in a new tab)

Use terms as a starting point; confirm with clinical context and appropriate testing.

Clinician mode: safer workflow suggestion
  • Capture photos through your EMR / approved secure capture workflow.
  • For suspected contagious exanthem, document exposure history and coordinate isolation/notification per local policy.
  • If using a clinical atlas platform, confirm data handling (storage, retention, device processing vs cloud).

Pattern maps (pregnancy dermatoses + infectious rashes)

Simple distribution sketches to “pattern-match” quickly (not diagnostic).

Polymorphic eruption of pregnancy (PEP / PUPPP)

Often starts in abdominal striae (late pregnancy), classically spares the umbilicus.

3rd trimester

Pemphigoid gestationis

Often periumbilical start → spreads; can blister. Consider biopsy/DIF when suspected.

2nd–3rd trimester

Atopic eruption / Prurigo of pregnancy

Often earlier; papules commonly on extensor limbs ± trunk; eczema-like in some.

1st–2nd trimester

Measles (rubeola) — maculopapular exanthem

Classically begins on head/face and spreads downward to trunk and extremities.

Infectious

Varicella (chickenpox) — vesicles in crops

Generalized pruritic rash progressing macules → papules → vesicles → crusts; lesions in different stages.

Infectious

Shingles (herpes zoster) — dermatomal

Vesicular clusters in 1–2 adjacent dermatomes; often unilateral and usually does not cross midline.

Infectious

Secondary syphilis — palms/soles pattern

Rash may involve palms and soles and is often rough/red/reddish-brown; usually not itchy.

Infectious
Palms Soles

Herpes simplex — grouped vesicles/ulcers

“Outbreak” lesions often present as blisters that break and leave painful sores (oral or genital).

Infectious
Localized cluster
Clinician mode: infectious rash reminders (non-exhaustive)
  • Measles: consider airborne precautions and public health notification per local policy; pregnancy may be higher-risk for adverse outcomes.
  • Varicella: confirm immunity/exposure history; coordinate isolation and management pathways per institutional protocol.
  • Zoster: dermatomal vesicles/pain; confirm distribution and exposure considerations for non-immune contacts.
  • Syphilis: palms/soles rash + systemic symptoms → test and treat per guidelines; pregnancy requires prompt management.
  • HSV: localized painful vesicles/ulcers; pregnancy management varies by gestational age/history—use protocol.

This section is intentionally high-level—use your institutional pathways, local public health guidance, and ID/derm consultation.

Quick differential helper

Pick timing + morphology + distribution → suggests likely buckets.

Inputs

Output is a structured “thinking aid.” If systemic symptoms, blistering, mucosal involvement, or concern for infection/drug reaction → escalate and/or consult dermatology/infectious disease.

Suggested buckets

Awaiting input…
  • Select inputs and click Generate suggestions.
Clinician mode: workup / management prompts
  • Pruritus out of proportion to rash (esp palms/soles): consider ICP evaluation (bile acids + LFTs) per protocol.
  • Periumbilical eruption ± blisters: consider pemphigoid gestationis; dermatology + biopsy with DIF often appropriate.
  • Dermatomal unilateral vesicles/pain: consider zoster; confirm distribution and exposure precautions per policy.
  • Face → downspread with fever/cough/conjunctivitis: consider measles; follow isolation/public health policy.
  • Generalized vesicles in crops / mixed stages: consider varicella; follow institutional pathways.
  • Palms/soles rash: broaden differential (incl. syphilis) and test per guidelines.

Reminders—not orders. Use local guidelines, allergies, comorbidities, and gestational age.

Suggested “photo set” for documentation
  • One close-up (fills frame) + one mid-range + one anatomic-context photo
  • Include scale marker (ruler/coin) when possible
  • Consistent lighting; avoid flash glare
  • Capture primary lesion before heavy excoriation if possible

EMR-ready note snippet (copy/paste)

Build a short, structured assessment/plan paragraph from your selections.

Clinician mode
Tip: add onset/timing, associated symptoms, and distribution. Avoid patient identifiers in any external destinations.

Patient education

Shareable photo checklist + “when to seek care” guidance.

Photo checklist handout

Use for patient portals / tele-derm style messaging when you request photos.

Printable
Suggested patient script (copy/paste)
“Please send 3 photos: (1) close-up, (2) mid-range, (3) body-location photo. Use good lighting, avoid flash glare, include a ruler/coin for scale, and tell us when it started and whether you have fever, cough, mouth sores, or new medications.”

When to seek urgent care

For potentially serious or contagious rashes.

Safety
Urgent signs
Seek urgent evaluation if there is fever with rash, rapid blistering, severe pain, shortness of breath, severe headache/neck stiffness, new confusion, mouth/eye involvement, or if you feel very ill.
Contagious rash note
Some rashes can be contagious. If you suspect exposure to measles, chickenpox/varicella, shingles, or other infections, call ahead before arriving so the clinic can plan appropriate precautions.

References & high-quality image libraries

Public, clinician-friendly starting points.

Pregnancy-specific dermatoses (overview)
Infectious rash: CDC clinical descriptions & images
Clinical atlas / decision support

Rash Photo Checklist (Patient Handout)

Please send 3 photos and a brief message. Good photos help us diagnose faster.

1) Close-up Fill the frame with the rash. Tap to focus. Avoid motion blur.
2) Mid-range Show a larger area (e.g., whole forearm/abdomen) so we see the pattern.
3) Location photo Stand back so we can see where it is on the body.
Scale marker Include a ruler/coin if possible. It helps measure size.
Lighting Bright room/daylight. Avoid flash glare and colored lights.
Message us When it started, how fast it spread, itch/pain, new meds, fever, cough, mouth sores.

If you have fever, mouth sores, rapid blistering, or feel very ill, seek urgent evaluation.