PUPPP

Diagnosis: PUPPP

PUPPP - Pruritic urticarial papules and plaques of pregnancy (PUPPP)

Clinical Presentation

PUPPP - Pruritic urticarial papules and plaques of pregnancy (PUPPP)

Clinical History

Intensely pruritic urticarial papules within striae on abdomen in 3rd trimester. Spares umbilicus. First pregnancy. No vesicles or bullae.

Treatment

Topical corticosteroids (first-line). Oral antihistamines. Short course of prednisone for severe cases. Reassurance — self-limited after delivery.

Differential Diagnosis

• Pemphigoid gestationis • Atopic eruption of pregnancy • Drug eruption • Urticaria • Contact dermatitis • Scabies

Key Learnings

• Pruritic Urticarial Papules and Plaques of Pregnancy — most common dermatosis of pregnancy • Typically starts in striae distensae of abdomen in 3rd trimester (primigravida) • Characteristically spares the umbilicus (distinguishes from pemphigoid gestationis) • Benign — no risk to mother or fetus • Resolves spontaneously after delivery (usually within days) • More common with excessive maternal weight gain, multiple gestations • Does NOT typically recur in subsequent pregnancies • DIF is negative (distinguishes from pemphigoid gestationis)

Tags: dermatology, kodachrome, PUPPP