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Pruritus

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Pruritic Urticarial Papules and Plaques of PregnancyAka: Polymorphic Eruption of Pregnancy, PUPPP

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  1. See Also
    1. Pruritus in Pregnancy
    2. Pruritus
  2. Epidemiology
    1. Occurs more commonly in primigravidas
    2. More common in third trimester
    3. Incidence: 0.4 to 0.6% of pregnancies
  3. Pathophysiology
    1. May be related to abdominal distention
  4. Risk Factors
    1. Increased maternal weight gain
    2. Fetal Macrosomia
    3. Twin Gestation
  5. Signs: Locations
    1. Onset over abdomen in 90% of cases (especially striae)
    2. Symmetric spread to thigh and buttock
    3. May also involve upper arm, back, and hands
    4. Does not involve face or periumbilical area
  6. Signs: Appearance
    1. Red 1-2 mm Papule with surrounding pale halo
    2. Lesions may coalesce into Urticarial Plaques
    3. Vesicles may also be seen
  7. Differential Diagnosis
    1. See Pruritus in Pregnancy
    2. See Pruritus Causes
    3. Erythema Multiforme (target lesion)
    4. Herpes Gestationis
    5. Pemphigoid Gestationis
  8. Management
    1. See Nonspecific Management of Pruritus
      1. Cool compresses
      2. Oatmeal Baths (e.g. Aveeno)
      3. Antihistamines (e.g. Hydroxyzine)
    2. Refractory cases of intolerable itching
      1. Topical Corticosteroids (Group V)
      2. Consider short course of Prednisone 40 mg PO qd
  9. Course
    1. Severity decreases within one week of onset
    2. Rash and symptoms persist on average 6 weeks
    3. Resolves with delivery
  10. References
    1. Gabbe (2002) Obstetrics, Churchill Livingstone, p. 1288
    2. Habif (1996) Dermatology, Mosby, p. 140

Pruritic urticarial papules and plaques of pregnancy (C0269680)

ConceptsDisease or Syndrome (T047)
EnglishPapular dermatitis of pregnancy, PEP - Polymorphic eruption of pregnancy, Polymorphic eruption of pregnancy, Pruritic urticarial papules and plaques of pregnancy, PUPPP, PUPPP - Pruritic urticarial papules and plaques of pregnancy
Spanishdermatitis papulosa del embarazo
Parent ConceptsDermatitis (C0011603), Pregnancy eruption (C0406790)
SourcesOMIM, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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