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Pruritic urticarial papules and plaques of pregnancy (PUPPP)

A chronic hives-like rash that strikes some women during pregnancy.

Associated with no long-term risk for either the mother or unborn child.

Frequently begins on the abdomen and spreads to the legs, feet, underarms, chest, and neck.

The face is usually also spared.

Stretching of the skin is a common factor, and is more common in mothers with large fundal measurements in those who are carrying large babies, twins, and triplets.

The papules and plaques often first appear in the stretch marks.

Seems to be more frequent in women carrying boys.

Occurs in about 1 in every 200 pregnancies.

Cause is unknown, but the distension of the skin occurs mostly in first pregnancies,in the third trimester and is more likely with multiple pregnancies.

No observed difference in the outcome of the pregnancy for mothers or babies.

Treatment of mild cases during pregnancy consists of topical moisturising creams or aqueous/emollient ointments.

Corticosteroid creams and ointments are used in more aggressive cases, and systemic corticosteroids can be used to treat very severe cases.

Usually resolves spontaneously within a week of delivery.

In a few women continue to experience symptoms long into the postpartum period.

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