Psoriasis and psoriatic arthritis are chronic illnesses that are prevalent in women of childbearing age. The aim of this review is to bring to light data regarding the effect of pregnancy and the postpartum period on psoriasis and psoriatic arthritis and to discuss the major theories underlying these changes. To date, evidence indicates a tendency toward improvement of psoriasis and psoriatic arthritis during pregnancy and a flare in the postpartum period. This is likely a consequence of physiologic adaptations during pregnancy and the subsequent loss of these protective factors in the postpartum period. Most prominent among these adaptations are hormonally induced changes in helper T cell (Th1, Th2, and Th17) cytokines. However, alterations in proteins and cell surface molecules also have been implicated. The relatively high prevalence of psoriasis and psoriatic arthritis in women of childbearing age mandates that patients, dermatologists, and obstetricians alike be knowledgeable of the gestational and postpartum changes that occur in these diseases.
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