Pruritic urticarial papules and plaques of pregnancy

PUPPP
Left side view of abdomen

Pruritic urticarial papules and plaques of pregnancy (PUPPP), known in the United Kingdom as polymorphic eruption of pregnancy (PEP),[1] is a chronic hives-like rash that strikes some women during pregnancy. Some skin changes are known to occur in people who are pregnant while other skin conditions, or dermatoses, that people have prior to getting pregnant will become altered or symptoms will increase. Pruritic urticarial papules and plaques of pregnancy (PUPPP) is one of many skin conditions that is specific to pregnancy and occurs in about 1 in every 160 (0.625%) of pregnancies.[2][3][4][5]

It presents no long-term risk for either the woman or fetus as there is no statistical increase of risk of premature labor or fetal loss, despite frequently severe pruritus.[6]

PUPPP usually first appears on the abdomen and often spreads to the legs, feet, arms, chest, and neck. The face is usually not affected.[7] Skin distension (stretching) is thought to be a possible trigger for PUPPP as it most commonly affects primigravida (women in their first pregnancy), those with large fundal measurements (distance from the pubic bone to the top of the uterus) and/or those who are carrying large babies or multiples. The papules and plaques often first appear within stretch marks before changing appearance and spreading to other areas of the body.

For those who may be experiencing signs and symptoms of PUPPP, it is strongly recommended they speak with their primary care physician and receive a consult from a dermatologist regarding skin changes during pregnancy.[6]

  1. ^ Matz H, Orion E, Wolf R (2006). "Pruritic urticarial papules and plaques of pregnancy: polymorphic eruption of pregnancy (PUPPP)". Clin Dermatol. 24 (2): 105–8. doi:10.1016/j.clindermatol.2005.10.010. PMID 16487883.
  2. ^ Elling, SV; McKenna, P; Powell, FC (September 2000). "Pruritic urticarial papules and plaques of pregnancy in twin and triplet pregnancies". J Eur Acad Dermatol Venereol. 14 (5): 378–81. doi:10.1046/j.1468-3083.2000.00026.x. PMID 11305379. S2CID 44551742.
  3. ^ Kroumpouzos, George; Cohen, Lisa M. (2003). "Specific dermatoses of pregnancy: An evidence-based systematic review". American Journal of Obstetrics & Gynecology. 188 (4): 1083–1092. doi:10.1067/mob.2003.129. ISSN 0002-9378. PMID 12712115.
  4. ^ Lambert, Julien (2016). "Itch in Pregnancy Management". Itch - Management in Clinical Practice. Current Problems in Dermatology. 50: 164–172. doi:10.1159/000446087. ISBN 978-3-318-05888-8. PMID 27578086.
  5. ^ Roth, Maria-Magdalena (2011). "Pregnancy dermatoses: diagnosis, management, and controversies". American Journal of Clinical Dermatology. 12 (1): 25–41. doi:10.2165/11532010-000000000-00000. ISSN 1179-1888. PMID 21110524. S2CID 5181650.
  6. ^ a b Kurien, George; Badri, Talel (2021), "Dermatoses of Pregnancy", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID 28613614, retrieved 2021-08-02
  7. ^ Tunzi M, Gray GR (January 2007). "Common skin conditions during pregnancy". Am Fam Physician. 75 (2): 211–8. PMID 17263216.