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Minimalist Lifestyle Blog
  • Pruritic Urticarial Papules and Plaques of Pregnancy or PUPPP
  • Tracy Freese
  • minimalist parenting
Pruritic Urticarial Papules and Plaques of Pregnancy or PUPPP

The skin disease Pruritic Urticarial Papules and Plaques of Pregnancy (PUPPP) or which is more commonly know in the United Kingdom as Polymorphic Eruption of Pregnancy (PEP) is a skin eruption or pregnancy rash that happens to women during pregnancy. It has been studied that Pruritic Urticarial Papules and Plaques of Pregnancy (PUPPP) is nevertheless a rare symptom that occurs in one incident out of 160 pregnancies. But in spite of its rare occurrences, this disease is still considered as one of the second most common skin dermatitis during the term of pregnancy apart from atopic eczema which is the most common skin problem that happens to pregnant woman all around the world. The exact underlying reason this skin disease is still unknown, but despite its undefined etiology it has been discovered that Polymorphic Eruption of Pregnancy (PEP) is associated with increased maternal weight gain that happens with multiple gestations. It has been propounded that Pruritic Urticarial Papules and Plaques of Pregnancy (PUPPP) occurs due to stretching of the abdominal skin during pregnancy which damages the underlying connective tissues that converts the nonantigenic ecules in the body to antigenic ones that leads to this kind of pregnancy rash. It has been noted that PEP usually occurs during the third semester of primagravidas (first pregnancy) while its recurrences in subsequent pregnancies is unusual. It has also been observed that Pruritic Urticarial Papules and Plaques of Pregnancy (PUPPP) is more likely to happen with women carrying multiples as it is found more common with woman giving birth to triplets rather than twins or singletons.

This harmless PUPPP skin lesion, which primarily appears late in the second trimester of pregnancy, is characterized by polymorphous non follicular papules, those that are erythematous, sometimes having vesicular plaque formation which begins over the abdomen sparing the periumbilical region during the onset of pruritis. Though Pruritic Urticarial Papules and Plaques of Pregnancy (PUPPP) rashes occurs more in the striae gravidarum (which means in the region of the pregnancy marks), which may soon spread to the upper torso of the body involving the breasts, arms and the also in the upper parts of the thighs. However pregnancy rash is uncommon in the facial region and also on soles of the feet, palms and other mucosal surfaces in the body.

The immunoflourosecence studies done on PUPPP skin lesion have always proved negative and the histopathological findings of Polymorphic Eruption of Pregnancy (PEP) are also nonspecific. Hence these lesions generally get resolved during the near term of the pregnancy or sometimes get cured naturally during the postpartum period after the child birth.

While maternal and fetal prognosis remains excellent in spite of this pregnancy rash, some of the case studies done with patients undergoing Pruritic Urticarial Papules and Plaques of Pregnancy (PUPPP), revels that this condition is more frequent in woman carrying boys. Statistically it has been noted that 70% of woman suffering from PEP deliver boys.

Although Polymorphic Eruption of Pregnancy (PEP) is never a threat to the patient or to the newborn, this skin lesion is highly uncomfortable for all pregnant women as the itching that is associated with pregnancy rash is often so unbearable that it causes hypertension which sometimes even lead to induction of labor.

Though clinically speaking the itching stage of Pruritic Urticarial Papules and Plaques of Pregnancy (PUPPP) last about one to two weeks, but in really according to majority of the patients those who have endured this pregnancy rash stated that the itch ‘really never goes away’ which makes it so unbearably uncomfortable for mothers experiencing this painful skin dermatitis during primigravida.

For woman those who are suffering from this kind of pregnancy rash it is advisable for them not to take hot water bath during the term of their pregnancy, as warm water tends to aggravate the itching sensations those that happens while suffering from Pruritic Urticarial Papules and Plaques of Pregnancy (PUPPP).It has beenobserved that a cold water shower not only makes the patents feel less distressed but it also makes the rashes temporary less traumatic, which makes the situation more endurable for a specific period of time. Adding an oatmeal bath preparation to the cold water bath also helps in suppressing the itching temporarily. Oatmeal bath preparations are available in most of the drug stores all around the globe, which helps in soothing the skin and thus bring temporary comfort for the patient.

At times when the itching gets too unbearable for woman who is suffering from Polymorphic Eruption of Pregnancy (PEP), one can also apply cold wet compression to the affected areas; so that the cold water compression can result in bring temporary relief to the itching areas on the body.

Its is also advisable not to wear any tight clothing while suffering from pregnancy rash as restricting the air way tends to aggravate the itching which produces more discomfort to patients suffering from Pruritic Urticarial Papules and Plaques of Pregnancy (PUPPP). Wearing light cotton clothes during the term of pregnancy not only reduces the itching but also makes the patients feel more relaxed and comfortable while suffering from this pregnancy rashes which generally occurs during the 35 weeks of gestation.

For patients suffering from Polymorphic Eruption of Pregnancy (PEP), it is recommended that they must avoid going out during the hottest part of the day, as sunrays falling on the affected areas of the body can intensify the itching which may result in serious discomfort for the patient while travelling on the road.

In milder cases patients suffering from Pruritic Urticarial Papules and Plaques of Pregnancy (PUPPP) rashes are often prescribed with mild topical steroid creams, those that are advised to be applied on the affected areas. Sometimes soothing moisturizing solutions are also prescribed for patients suffering from pregnancy rash which can be used regularly to bring relief from these itching problems. Moisturizing creams and certain other emollients for bath are also prescribed at times to all patients suffering from this disease, so that using them can produce temporary relief to the itching problems those that are associated with Polymorphic Eruption of Pregnancy (PEP).

Pregnancy rashes are indeed very itchy and uncomfortable. However if you are suffering from the same, it is best not to scratch the itching spots as that may damage your skin. Corticosteroid ointments and creams are also usually prescribed when conditions reach it extreme severity. Oral corticosteroid is also given to patients suffering from Polymorphic Eruption of Pregnancy (PEP), so that the conditions don’t run out of control during primagravidas.  

Antihistamine tablets are also given to patients suffering from pregnancy rash but it has been clinically found that corticosteroid creams and ointments are by far the best remedy for treating patients suffering from Polymorphic Eruption of Pregnancy (PEP).

It may be noted over here that Polymorphic Eruption of Pregnancy (PEP) is a condition that does not runs in the family and so it can be well assumed that patients who are suffering from pregnancy rashes need not worry about their fellow family members who are also pregnant or shall get pregnant to suffer from this disease.

Diagnosis of pregnancy rash is often done by visualizing the appearance and distribution pattern of this rash. However for making a confirmation of the disease, taking a sample of the skin which is also know as a skin biopsy is more advisable, when in certain cases the rash may look like other skin disease which can happen due to adverse drug reactions or even when they look more like eczema.

As Caesarean section is often not recommend for patients suffering from Pruritic Urticarial Papules and Plaques of Pregnancy (PUPPP), normal delivery is often a better producer which is followed in patients suffering from pregnancy rash.

For mothers those who are breastfeeding on their newborns it is a good news that though Polymorphic Eruption of Pregnancy (PEP) is a very irritating disease which can often remain for few weeks after the delivery of the newborn, never the less, pregnancy rashes does not appear to effect the well being of the nursing baby. Even for mothers those who are dependent on ingesting oral steroids or using corticosteroid creams for easing the discomfort caused by the pregnancy rash, can still be encouraged to breastfeed their babies as only negligible amount of steroid does pass on to the breast milk which does not necessarily effects the baby’s heath in the long run.

So patients those who are pregnant for the first time and does feel itching problems followed by rash with wheals which looks more akin to nettle rash or hives it is advisable to consult both the gynecologist and the dermatologist to check whether it is pregnancy rash which has occurred due to Polymorphic Eruption of Pregnancy (PEP). A pregnancy rash also sometimes looks like blisters which when scratched leaks out straw colored fluids and cause crust to form on the oozing sites at a late stage.

However as their has been no report till date of baby being affected by the Pruritic Urticarial Papules and Plaques of Pregnancy (PUPPP) rashes, one should not worry all that much when passing though this nasty itching disease, which generally gets cured in most of the cases after the birth of the child.X

NOTE: So what does this PUPPP stuff have to do with minimalist living? Nothing, except for the fact that I have had the distinct misery of suffering from this disorder and wanted to save other mothers the time and energy I spent scouring the Internet for information on cause and remedies. Since I have a blog at my finger tips, I decided to do a series of entries on the subject so please use the tags found on the upper right hand side of this page to view other "PUPPP" entries. As for remedies, click on the Amazon link and lather up for relief. Grandpa's Pine Tar Soap is the best resolution to your problem. The soap is cheap and highly effective, grab your debit card and order now! See PUPPP entry #3 for more details! -TF

  • Tracy Freese
  • minimalist parenting