Mild and moderate strengths are not associated with adverse pregnancy outcomes, whereas high-and ultrapotent agents pose a small risk for fetal-growth restriction with large cumulative doses (Chi, 2013, 2015). Even then, this risk is less than that with systemic corticosteroids. Importantly, with any topical agent, factors that increase systemic absorption include a large surface area treated, compromised epidermal barrier, occlusive dressings, prolonged treatment duration, and coadministration of topical agents that increase absorption.
The list of other agents used for dermatological conditions is extensive. For use in pregnancy and lactation, Murase (2014) and Butler (2014) have compiled tables and evidencebased descriptions of most. Notable therapeutic agents to avoid during pregnancy include methotrexate, psoralen plus ultraviolet A, mycophenolate mofetil, podophyllin, and systemic retinoids. hese are discussed in more detail in Chapter 12. Bacterial infections are a potential secondary complication of skin disorders and are treated promptly with oral antimicrobial agents with gram-positive coverage.
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