Background: The skin changes in pregnancy can be either physiological, changes in pre–existing skin diseases or development of new pregnancy specific dermatoses. Though cutaneous changes in pregnancy are a common occurrence but very limited  data is available on females in North India. Aims: The objective was to study the clinical spectrum of cutaneous manifestations in pregnant females, to differentiate between the physiological and pathological skin changes and categorize these as dermatoses specific and non–specific to pregnancy. Methods: In this cross–sectional observational study 200 patients presenting with cutaneous complaints irrespective of their parity and gestational age were included. Thorough examination and relevant investigations were done wherever necessary. Results: Pigmentary changes were the most common physiological change observed. Linea nigra in 129 patients (64.5%), darkening of areolae  in 113 (56.5%) cases and melasma, the most common physiological change of cosmetic concern was seen in 109(54.5%) cases. Most common complaint was pruritus 123 cases (61.5%). Co–existence of physiological and pathological dermatoses was common among our patients. Specific dermatoses of pregnancy included 44 cases (22%), most common was Atopic Eruption of Pregnancy 26 (13%) cases followed by polymorphic eruption of pregnancy 14 (7%) cases and Intrahepatic cholestasis of pregnancy and Pemphigoid gestationis 2 (1%) cases each. We encountered only one (0.5%) case of Uncertain Dermatoses of pregnancy (Impetigo Herpetiformis).

Conclusion: Physiological changes are the most common dermatoses associated with pregnancy. Co–existence of physiological and pathological dermatoses is common. Most common cutaneous complaint with which pregnant females present is pruritus. The specific dermatoses of pregnancy which have a poor prognosis are fortunately of rare occurrence, but early recognition and prompt treatment is crucial to improve maternal and fetal prognosis and  minimize  morbidity.