Skin Changes

In addition to the skin changes of the breast already discussed, hyperpigmentation is common, especially in women with dark hair and a dark complexion. The linea alba darkens to become the linea nigra, as shown in Figure 23-7A. Areas prone to friction (e.g., medial thighs, axilla) also tend to darken. New pigmentation on the face, called chloasma, also commonly develops on the cheeks, forehead, nose, and chin. These skin changes are caused by the presence of high levels of ovarian, placental, and pituitary hormones. A woman with chloasma appears in Figure 23-7B.

''Stretch marks,'' or striae gravidarum, are irregular, linear, pinkish-purple lesions that develop on the abdomen, breasts, upper arms, buttocks, and thighs. They are caused by tears in the connective tissue below the stratum corneum. Figures 23-8 and 23-9 show striae gravidarum of the abdomen and breasts, respectively. The linea nigra is also present on the patient in Figure 23-8. Figure 23-10 illustrates the common skin changes seen in pregnancy.

Transverse grooving, as well as increased brittleness or softening, of the nails may occur. Eccrine sweating progressively increases throughout pregnancy, whereas apocrine gland

Figure 23-8 Striae gravidarum of the abdomen. Note also the linea nigra.

Figure 23-8 Striae gravidarum of the abdomen. Note also the linea nigra.

Bico Viuva

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Stretch Marks

Stretch Marks

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