Exploring the Relationship between Psoriasis and Pregnancy Pratiksha Patra, BA- MSII University of South Florida Morsani College of Medicine INTRODUCTION: • Psoriasis affects millions of adults and is one of the most common autoimmune disorders in the US.1 Previous studies stress the possible negative teratogenic effects of continuing biologic medications during pregnancy and recommend the use of topical treatments during this time instead.3, 4 It is commonly believed that psoriasis symptoms tend to improve during pregnancy, however, there is limited research documenting the extent to which this occurs3, 4 and how. The aim of this literature review was to thoroughly examine the published literature on the relationship between psoriasis and pregnancy to elucidate possible new routes of treatment. METHODS: 1. Searches were primarily conducted in three databases (PubMed, Scopus, and Embase) available via the University of South Florida library network. Searches were also conducted in Cochrane and clinicaltrials.gov and yielded no relevant results. Articles for consideration to be included in this literature review focused on the presentation of psoriasis during pregnancy. 2. Data coding followed Saldaña’s (2016) methods of first cycle and second cycle coding. First cycle coding began with the researcher hand coding all articles into an Excel file using an a priori code list adopted from Boote and Beile’s (2005) Literature Review Scoring Rubric.10 3. As codes were identified, a master code list was developed. Second cycle coding involved theming of the data allowing for codes to combine and emerge as categories.11 Coding ended with code weaving to create a narrative to see how categories and emergent themes fit together to answer the guiding questions for this review.11 EXAMPLE CODES: DISCUSSION + CONCLUSION: • Collectively, these findings elucidate the individual nature of psoriasis and identify progesterone as a possible non-teratogenic therapy. Primarily, the presence of the HLA-Cw6 allele in a woman’s genome along with the individual variation of estrogen receptors reinforces the researcher’s recommendation for genetic testing following a psoriasis diagnosis. This genetic testing may allow patients and physicians to best understand what to expect of psoriasis during pregnancy as well as help determine the most efficacious treatment course to follow. Findings from this review help close the gap in literature on this topic as well as educate physicians and pregnant psoriasis patients on how their psoriasis might progress during pregnancy and postpartum. REFERENCES: 1. Armstrong, A.W., et al., Psoriasis Prevalence in Adults in the United States. JAMA Dermatol, 2021. 157(8): p. 940-946. 2. Lambert, J.L.W., et al., Practical recommendations for systemic treatment in psoriasis according to age, pregnancy, metabolic syndrome, mental health, psoriasis subtype and treatment history (BETA-PSO: Belgian Evidence-based Treatment Advice in Psoriasis; part 1). J Eur Acad Dermatol Venereol, 2020. 34(8): p. 1654-1665. 3. Simionescu, A.A., B.M. Danciu, and A.M.A. Stanescu, State-of-the-art review of pregnancy-related psoriasis. Medicina (Lithuania), 2021. 57(8). 4. Mervic, L., Management of moderate to severe plaque psoriasis in pregnancy and lactation in the era of biologics. Acta Dermatovenerol Alp Pannonica Adriat, 2014. 23(2): p. 27-31. 5. Parisi, R., et al., National, regional, and worldwide epidemiology of psoriasis: systematic analysis and modelling study. Bmj, 2020. 369: p. m1590. 6. Gratton, R., et al., Unraveling the Role of Sex Hormones on Keratinocyte Functions in Human Inflammatory Skin Diseases. Int J Mol Sci, 2022. 23(6). 7. Hoffman, M.B., M. Farhangian, and S.R. Feldman, Psoriasis during pregnancy: characteristics and important management recommendations. Expert Rev Clin Immunol, 2015. 11(6): p. 709-20. 8. Danesh, M. and J.E. Murase, The immunologic effects of estrogen on psoriasis: A comprehensive review. Int J Womens Dermatol