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Pruritic Urticarial Papules and Plaques of Pregnancy (PUPPP)

Figure 3.40 A: PUPPP diagram* B: PUPPP* C: Prurigo of pregnancy* *Reprint from Ingber A. Obstetric Dermatology: A Practical Guide. New York, NY: Springer; 2008
Figure 3.40
A: PUPPP diagram*
B: PUPPP*
C: Prurigo of pregnancy*
*Reprint from Ingber A.
Obstetric Dermatology:
A Practical Guide. New York,
NY: Springer; 2008
(Figure 3.40A, B)
  • Most common pregnancy-related dermatosis; late third trimester (± immediate postpartum) in first pregnancies (primigravida); risk ↑ with twins and maternal obesity; diagnosis of exclusion
  • Presents with intensely pruritic papules arising w ithin striae of abdomen (sparing periumbilical area unlike PG), ± vesicles, target or annular lesions; typically does not recur with subsequent pregnancies
  • Histology: nonspecific findings including epidermal changes (spongiosis, parakeratosis) and perivascular lymphocytic infiltrate with dermal edema
  • DIF: negative
  • Fetal risk: none
  • Treatment: anecdotal; potent topical corticosteroids and oral antihistamine, resolution 7–10 days after delivery

 

 

 

 

 

 

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