During pregnancy, several physiological, hormonal, immunological, metabolic and vascular changes occur [1]. The skin is one of the first organs that maybe affected. We report a case of a sudden whitish macular eruption on the belly that occurred at 30 weeks of pregnancy.
Case Presentation
A 33-year-old female patient with no particular medical history at 36 weeks of pregnancy developed a white macule with irregular borders on the belly with a downward extension which has occurred 6 weeks before (Figure 1) (Figure 2). The patient didn’t complain about itch or pain, and no sclerosis or scales were present on physical examination.
Figure 1
White macule of the belly with a downward extension and irregular borders in a 36 week pregnant women.
Figure 2
Disappearance of the lesion after childbirth.
Conclusions
Pregnancy dermatoses are classified into: structural skin changes, specific dermatoses of pregnancy and preexisting dermatosis of pregnancy [2]. A rare condition characterized by the presence of a whitish macular eruption of the belly is often a cause of concern in pregnant women. The “white belly button” is a benign physiological phenomenon; it appears as a sudden demarcation of “white areas” or a “skin pallor” that affects the skin due to a vascular abnormality resulting from an excessive stretching of the skin. The abrupt onset of this macule has never been described or reported in any scientific journal and the physio-pathological mechanism remains unknown but can be explained by the presence of a tissue hypoxia as a result of vasoconstriction of small dermal vessels.It is therefore important to differentiate this physiological pigmentation from other skin conditions such as post inflammatory hypopigmentation, vitiligo, nevus depigmentosus pityriasis versicolor and white spot disease to avoid unnecessary treatment and to reassure pregnant women about the benignity of this condition.
Figure 1
Figure 2