AKA
- Pruritic urticarial papules and plaques of pregnancy (PUPPP)
- Toxic erythema of pregnancy
- Late-onset prurigo of pregnancy
- Toxemic rash of pregnancy
Epidemiology
- ~1/160 deliveries (common)
- Primiparous women
- Multiple gestations and male fetuses
Mechanism: unknown
- Possibly due to rapid, late stretching of abdominal skin
- → damage of connective tissue → allergic like reaction (cross-reactivity to collagen)
Onset timeline in pregnancy
- Late 3rd trimester or postpartum (striae only develop later on in pregnancy)
Clinical presentation
- Begins in striae
- Periumbilical sparing
- Polymorphous
- Edematous pruritic urticarial plaques
- Sometimes with vesiculation
- May have pseudo-targetoid like appearance
DDx:
- Urticarial gestational pemphigoid - appear earlier during gestation, have no association with abdominal striae and often involve the umbilicus
- Urticária
- Exantema maculopapuloso a fármaco ou para-viral
Prognóstico
- Resolve espontaneamente ao fim de 4 semanas
- No maternal or fetal risks
- Unlikely to reccur
Treatment
- Topical corticosteroids
- Oral antihistamines
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