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Pruritic Urticarial Papules and Plaques of Pregnancy

Pep Polymorph Erup of Preg


Presentation

  • Although the clinical presentation of this patient was typical of that of PUPPP, it demonstrates an unusual time course with its postpartum presentation.[ncbi.nlm.nih.gov]
  • Pruritic urticarial papules and plaques of pregnancy presenting in the postpartum period is extremely rare.[ncbi.nlm.nih.gov]
  • This article presents an unusual case to demonstrate a variation in presentation of this disease as well as a unique course of treatment. The unusual progression of this case may render new insight regarding the etiologic factor of this disease.[ncbi.nlm.nih.gov]
  • Because of her unusual presentation, she was thought initially to have pemphigoid gestationis. Subsequent dermatological evaluation and a biopsy confirmed the diagnosis of PUPPP.[ncbi.nlm.nih.gov]
  • Lesions are frequently present centrally and are intensely pruritic. Mucous membranes are usually not involved. Histology shows a normal epidermis with mild perivascular lymphohistiocytic infiltrate.[ncbi.nlm.nih.gov]
Asymptomatic
  • Nine days post-delivery, the patient developed back pain radiating to her right leg, but she was otherwise asymptomatic. She was afebrile; with a slightly tender, non-erythematous, non-draining, 1 cm nodule at the epidural catheter site.[ncbi.nlm.nih.gov]
Lymphedema
  • Member Rated 0 Patient case no. 235 Date added 01 January 1990 Patient details Age --Undetermined-- Localisation Primary Lesions Pathophysiology vascular disorders, vasculitis and purpuras / lymphatic disorders / lymphedema Symptoms Diagnosis lymphedema[dermquest.com]
HELLP Syndrome
  • National Library of Medicine Previous Document: Plasma VEGF levels are increased in women with severe preeclampsia or HELLP syndrome Next Document: Investigation of a fetal heart-rate pattern that shows a reduced oscillation amplitude[biomedsearch.com]
Papule
  • On examination, erythematous papules and urticarial plaques were present in the striae of the abdomen and buttocks and involved the legs, arms and back.[ncbi.nlm.nih.gov]
  • We propose that this entity be termed "pruritic urticarial papules and plaques of pregnancy (PUPPP)".[ncbi.nlm.nih.gov]
  • A 30-year-old woman developed pruritic urticarial papules and plaques of pregnancy (PUPPP).[ncbi.nlm.nih.gov]
  • We evaluated the hormonal profile and the autoimmune background in 11 pregnant women with pruritic urticarial papules and plaques of pregnancy.[ncbi.nlm.nih.gov]
  • Pruritic urticarial papules and plaques of pregnancy presenting in the postpartum period is extremely rare.[ncbi.nlm.nih.gov]
Urticaria
  • One week after starting this medication, the pruritus had resolved and the erythema/urticaria had abated; the pigmentary alteration had improved, but still remained. The PUPPP did not return after parturition.[ncbi.nlm.nih.gov]
  • […] plaques of pregnancy Member Rated 0 Patient case no. 235 Date added 03 November 2003 Patient details Age --Undetermined-- Localisation Trunk / abdomen Primary Lesions Papule / erythematous Plaque / erythematous Pathophysiology pregnancy-related dermatoses urticaria[dermquest.com]
  • Like other forms of urticaria, PUPPP can be treated with topical steroid creams. Although antihistamines such as Benadryl are not as effective for PUPPP, they are sometimes prescribed as well.[ic.steadyhealth.com]
  • Signs: Appearance Red 1-2 mm Papule with surrounding pale halo Lesions may coalesce into Urticaria l Plaque s Vesicle s may also be seen VII. Differential Diagnosis VIII.[fpnotebook.com]
  • If the rash does not appear typical for PUPPP, then other conditions to consider might include but are not limited to prurigo gestationis, atopic eruption of pregnancy, impetigo herpetiformis ,contact dermatitis, a drug reaction, urticaria, viral exanthem[obfocus.com]
Eczema
  • Home About Categories Skin Infections Bacterial Infections Viral Infections Fungal Infections Parasitic Infestations Eczema Psoriasis Acne and Rosacea Photosensitive Dermatoses Pigmentary Disorders Connective Tissue Disorders Skin Tumours Metabolic Disorders[dermatologyoasis.net]
  • However over half develop multiple forms (polymorphic) with erythema (redness), vesicle s (small blisters), and targetoid and eczema tous (eczema-like) lesions.[en.academic.ru]
  • Some common causes are Allergic reactions to food, insect bites, pollen, and medicines Skin conditions such as eczema, psoriasis, and dry skin Irritating chemicals, cosmetics, and other substances Parasites such as pinworms, scabies, head and body lice[icdlist.com]
  • A skin biopsy of the rash is only performed if the doctor suspects another cause such as: • Eczema of pregnancy. • Atopic Eruption of Pregnancy (AEP) previously called prurigo of pregnancy. • Pruritic folliculitis of pregnancy: widespread itchy rash.[womens-health-advice.com]
  • PUPPP is second only to eczema as the most common far of the pregnancy dermatoses, with a worldwide incidence of 1:160 pregnancies. It shows no predilection for any particular ethnicity.[dermatologyadvisor.com]
Pruritic Rash
  • A 25-year-old woman complained of an intensely pruritic rash for 2 days. The rash began 10 days postpartum. It began on her abdomen and spread to her buttocks, legs and upper arms.[ncbi.nlm.nih.gov]
  • For patients with a widespread, intensely pruritic rash or those with inadequate response to topical therapy, a short course of systemic glucocorticoids may be prescribed.[aocd.org]
  • A primigravid 24-year-old woman at 34-weeks gestation comes to the clinic because of a pruritic rash that has been developing on her abdomen over the last week. She is otherwise well and has had normal prenatal visits and blood work.[usmleforum.com]
Skin Plaque
  • Itchy, bumpy hives and plaques develop usually on the abdominal area Symptoms - Pruritic urticarial papules plaques of pregnancy * Itching * Bumpy hives * Skin plaques Causes - Pruritic urticarial papules plaques of pregnancy Pregnancy Prevention - Pruritic[checkorphan.org]

Workup

  • Utilization of a broad base of clinicopathologic and laboratory criteria is important in the workup of a patient with an eruption of pregnancy.[ncbi.nlm.nih.gov]

Treatment

  • Investigation of new treatment options has been limited by patient concerns about the negative fetal effects of medication. To assess the efficacy of intramuscular injection of autologous whole blood (AWB) for treatment of PUPPP.[ncbi.nlm.nih.gov]
  • Most reports of the effective treatment of PUPPP involve high potency topical corticosteroids or oral steroids. Many authorities have noted cases of PUPPP whose resolution followed parturition.[ncbi.nlm.nih.gov]
  • Pruritic urticarial papules and plaques of pregnancy is considered the most common pruritic skin condition seen in pregnancy, and its classic presentation and treatment options have been well described.[ncbi.nlm.nih.gov]
  • The first case responded to treatment with moderately potent topical steroids while the second case required a short course of systemic steroids. Our first case is the only reported case of PEP occurring during a triplet pregnancy.[ncbi.nlm.nih.gov]
  • Treatment should be directed toward symptomatic relief only.[ncbi.nlm.nih.gov]

Prognosis

  • The maternal and fetal prognosis is excellent. Treatment consists of topical or oral corticosteroids. Delivery does not usually provide relief of symptoms.[ncbi.nlm.nih.gov]
  • The maternal and fetal prognosis are generally unaffected, and the condition is usually responsive to topical corticosteroids and oral antihistamines.[ncbi.nlm.nih.gov]
  • The prognosis is favorable. We report a case of PUPPP in a primipara and review the clinical signs, differential diagnosis, possible etiologic factors, diagnosis, and therapy.[ncbi.nlm.nih.gov]
  • Careful dermatological examination and cutaneous biopsy can assist in differentiating PUPPP from pemphigoid gestationis, which is essential for treatment and prognosis.[ncbi.nlm.nih.gov]
  • , Prevention, and Complications Prognosis resolves typically in 4-6 weeks or within 2 weeks postpartum no risk of fetal or maternal morbidity Please rate topic.[medbullets.com]

Etiology

  • We report a case of PUPPP in a primipara and review the clinical signs, differential diagnosis, possible etiologic factors, diagnosis, and therapy.[ncbi.nlm.nih.gov]
  • The unusual progression of this case may render new insight regarding the etiologic factor of this disease.[ncbi.nlm.nih.gov]
  • While the etiology of PUPPP is unknown and the clinical features (urticarial plaques) sometimes overlap with those of other dermatoses of pregnancy, we regard PUPPP as a distinct entity.[ncbi.nlm.nih.gov]
  • […] therapy, etiology, pathology Urticaria / diagnosis*, drug therapy, etiology, pathology Chemical Reg.[biomedsearch.com]
  • Etiology is unknown. Treatment should be directed toward symptomatic relief only.[ncbi.nlm.nih.gov]

Epidemiology

  • OBJECTIVE AND METHODS: To describe the epidemiological, clinical, and histopathological findings of all patients diagnosed with PUPPP at the American University of Beirut Medical Center (AUB-MC) between 1998 and 2009 and compare our findings with those[ncbi.nlm.nih.gov]
  • This article reviews the epidemiology, clinical manifestation, etiology, differential diagnosis, and treatment of PUPPP.[ncbi.nlm.nih.gov]
  • Introduction Pruritic urticarial papules and plaques of pregnancy ( PUPPP ) or polymorphic eruption of pregnancy (PEP) A self-limited pruritic inflammatory disorder of the skin occurring in the last trimester of pregnancy or immediately postpartum Epidemiology[medbullets.com]
Sex distribution
Age distribution

Pathophysiology

  • […] elephantiasis nostras verrucosa Member Rated 0 Patient case no. 235 Date added 01 January 1990 Patient details Age --Undetermined-- Localisation Primary Lesions Pathophysiology vascular disorders, vasculitis and purpuras / lymphatic disorders / elephantiasis[dermquest.com]

Prevention

  • If necessary, you can wear gloves to prevent scratching. o Some women feel that cool baths help.[cyndiayoub.com]
  • Differential Diagnosis Pemphigoid gestationis Erythema multiforme Other drug reaction rash Treatment Initial therapy mid-to-high potency topical steroids If refractory systemic corticosteroids with quick taper Anti-histamines for pruritus Prognosis, Prevention[medbullets.com]
  • Can I prevent PUPPP? Unfortunately, there are none. If you're going to get PUPPP, you're going to get it. Try to remember, though, that it's temporary and will disappear soon after your beautiful baby is born.[whattoexpect.com]
  • Can you prevent PUPPPs? Sadly, no. There's no way to predict who will get it, and there's nothing you can do to prevent it.[fitpregnancy.com]
  • Itchy, bumpy hives and plaques develop usually on the abdominal area Symptoms - Pruritic urticarial papules plaques of pregnancy * Itching * Bumpy hives * Skin plaques Causes - Pruritic urticarial papules plaques of pregnancy Pregnancy Prevention - Pruritic[checkorphan.org]

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