Pruritic Papules and Plaques of Pregnancies, or PUPPP, is a skin condition that can affect women during pregnancy. When present, the rash usually appears in the third trimester of pregnancy. PUPPP is thought to be caused by damage to tissue from skin stretching. Although PUPPP may look severe and be extremely itchy, the condition is not considered dangerous to mom or baby.
The severity of PUPPP and its symptoms can vary from woman to woman. For some pregnant women, the itching is mild and the rash may only encompass a small area. With mild PUPPP, interference in life can by minimal. For other women, symptoms are severe. The itching can be intense. A pregnant woman with severe PUPPP can have a rash spread over her entire body and high interference with activities and sleep.
There is no cure for PUPPP. Treatment is focused on relief of symptoms. Skin creams and steroids to relieve itching and antihistamines to relieve allergic reactions are commonly prescribed. Diagnosis of PUPPP in pregnancy is made on the appearance of the rash. In rare cases a skin biopsy is needed to rule out other pregnancy skin conditions. Pruritic Papules and Plaques of Pregnancy usually disappears soon after delivery, although it can linger in some women.
Small, reddish pink pimples and hives are characteristic of PUPPP. The rash usually begins in the abdomen, but the rash can spread beyond the stomach to many other parts of the body. The rash of PUPPP does not affect the belly button. To see pictures of PUPPP, go here.
Other skin conditions in pregnancy that may be confused with PUPPP:
Prurigo Gestationis is a skin condition in pregnancy that produces tiny bumps usually found on the hands, arms, feet, and legs. The bumps appear similar to bug bites. Prurigo Gestationis is not considered dangerous to mother or baby.
Herpes Gestationis is another skin condition that can affect pregnant women. Despite the name, the skin condition is not related to the herpes virus. With this condition, a rash develops into large blisters. Unlike PUPPP, Herpes Gestationis can be dangerous in pregnancy. Preterm labor and growth problems for the baby in the uterus can occur from Herpes Gestationis.
PUPPP affects up to 1% of all pregnancies. About 70% of women inflicted with PUPPP are pregnant with boys. It is most common in twin and first pregnancies. A woman is not likely to experience PUPPP again in subsequent pregnancies. Although Pruritic Papules and Plaques of Pregnancy can be very uncomfortable and the rash can have an unpleasing appearance, PUPPP is not a dangerous skin condition of pregnancy.
DermNet NZ PUPPP
Pregnancy Etc. What is PUPPP?