Pruritic Urticarial Papules and Plaques of Pregnancy

Synonyms

Toxemic rash of pregnancy; Late-onset prurigo of pregnancy; Toxic erythema of pregnancy; Polymorphic eruption of pregnancy; PUPPP

Definition and Characteristics

Pruritic urticarial papules and plaques of pregnancy (PUPPP) is a common benign inflammatory dermatosis specific to pregnancy. It most often involves primigravidae at late term and tends not to recur in subsequent pregnancies. The eruption usually starts in the last trimester (85%), most commonly between 36 and 39 weeks gestation, or within days after delivery (15%) [1]. Earlier occurrence is very rare. Pruritic erythematous edematous papules and plaques appear almost invariably first in the striae distensae of the lower abdomen. Sparing of the periumbilical region is typical. The lesions quickly become generalized involving also other parts of the body such as the buttocks, thighs, lateral parts of the trunk, and arms. Facial involvement is rare as is the involvement of palms and soles; however, if the latter are...