Pruritic urticarial papules and plaques of pregnancy

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Pruritic urticarial papules and plaques of pregnancy (PUPPP), also known as polymorphic eruption of pregnancy, is a skin condition that occurs during the third trimester of pregnancy. It is characterized by itchy, red, raised bumps and patches on the skin, primarily affecting the abdomen, but can also spread to the thighs, buttocks, and arms.

Symptoms[edit | edit source]

The primary symptom of PUPPP is intense pruritus (itching) accompanied by the appearance of red, raised bumps and patches. These lesions often start in the striae distensae (stretch marks) and can spread to other parts of the body. The condition typically spares the face, palms, and soles.

Causes[edit | edit source]

The exact cause of PUPPP is unknown. It is more common in first pregnancies and multiple pregnancies, suggesting a possible link to hormonal changes or skin stretching.

Diagnosis[edit | edit source]

Diagnosis is primarily based on clinical examination. A skin biopsy may be performed to rule out other conditions such as pemphigoid gestationis, intrahepatic cholestasis of pregnancy, and atopic eruption of pregnancy.

Treatment[edit | edit source]

Treatment focuses on relieving symptoms. Topical corticosteroids and antihistamines are commonly prescribed. In severe cases, oral corticosteroids may be considered. The condition usually resolves on its own shortly after delivery.

Prognosis[edit | edit source]

The prognosis for PUPPP is excellent. Symptoms typically resolve within a few days to weeks after delivery, and there are no long-term effects on the mother or baby.