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Query: UMLS:C0033774 (pruritus)
 14,546 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Pruritic urticarial papules and plaques of pregnancy (PUPPP) was recently defined as an intensely pruritic cutaneous eruption occurring in the third trimester. We are reporting fifteen additional cases of this distinctive eruption. The lesions began in the third trimester in all but two patients. The rash consisted of a symmetric eruption of papules, urticarial lesions, and some erythema multiforme-like target lesions. Histologic examination showed a mild nonspecific lymphohistiocytic perivasculitis. Moderate or intense pruritus was present in all but one case. The abdomen and proximal extremities were most commonly involved, but two patients had lesions only on the lower legs. Clearing occurred prior to delivery (five cases), within 1 week of delivery (nine cases), and at 6 weeks postpartum (one case). The pruritus was decreased with topical corticosteroids and diphenhydramine in all cases except one. Fetal wastage did not occur. Subsequent pregnancies were uneventful in two patients. PUPPP is a benign dermatosis of pregnancy which resolves spontaneously or with delivery.
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PMID:Pruritic urticarial papules and plaques of pregnancy (PUPPP). A clinicopathologic study. 728 54

Pruritus is the leading dermatological symptom during pregnancy. Besides preexisting or acquired dermatoses, there are a number of pregnancy-specific dermatological diseases such as PEP (polymorphic eruption of pregnancy, previously named PUPPP), pemphigoid (herpes) gestationis, and pruritus gravidarum that are accompanied by severe itching and scratching. Because of potential effects on the fetus, the treatment of pruritus in pregnancy requires prudent consideration. The use of topical and systemic treatments depends on the underlying aetiology of pruritus and the stage and status of the skin. In general, emollients, topical anti-pruritics and topical corticosteroids appear to be the safest options for localised forms of pruritus in pregnancy whereas systemic treatments and/or UV phototherapy are adequate for generalized pruritus. Systemic corticosteroids and a restricted number of antihistamines may be administered in severe cases. This paper highlights the major aetiologies of pruritus during pregnancy and points out the cornerstones of antipruritic therapy in recognition of our own clinical experiences and the current literature.
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PMID:[Pruritus in pregnancy. A frequent diagnostic and therapeutic challenge]. 1553 15

Dermatoses related to pregnancy or the postpartum period are known as the specific dermatoses of pregnancy. These dermatoses include (a) pemphigoid gestationis (synonym: herpes gestationis), (b) polymorphic eruption of pregnancy (synonym: pruritic urticarial papules and plaques of pregnancy; PUPPP), (c) prurigo of pregnancy and (d) pruritic folliculitis of pregnancy. Of these disorders, only pemphigoid gestationis has a known cause: an allogeneic immune reaction of the mother to the placental basal membrane. Itching or an itchy skin eruption is often the main symptom ofa dermatosis of pregnancy. During the diagnostic process, the possibility of a pre-existing or de novo skin disorder unrelated to the pregnancy should be considered. Correct diagnosis is important for the choice of treatment and for the prognosis of mother and child, because some dermatoses of pregnancy, such as pemphigoid gestationis, constitute a health risk.
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PMID:[Specific dermatoses of pregnancy]. 1688 90

Pruritic urticarial papules and plaques of pregnancy (PUPPP) is among the most common dermatoses of pregnancy. Most reports of the effective treatment of PUPPP involve high potency topical corticosteroids or oral steroids. Many authorities have noted cases of PUPPP whose resolution followed parturition. A few have noted that PUPPP can arise and resolve the third trimester. A 36-year-old prima gravida at 38 weeks of gestation presented with a 2-week history of a pruritic papular abdominal eruption. She used fluticasone propionate 0.05 percent lotion twice a day. One week after starting this medication, the pruritus had resolved and the erythema/urticaria had abated; the pigmentary alteration had improved, but still remained. The PUPPP did not return after parturition. PUPPP can abate entirely during pregnancy. Fluticasone propionate 0.05 percent lotion, a class 5 (low-medium potency) corticosteroid, has a benign side effect profile and should be considered for the treatment of PUPPP during pregnancy.
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PMID:Pruritic urticarial papules and plaques of pregnancy wholly abated with one week twice daily application of fluticasone propionate lotion: a case report and review of the literature. 1909 42

Pregnancy-specific dermatoses include polymorphic eruption of pregnancy, atopic eczema of pregnancy, and pemphigoid gestationis. Intrahepatic cholestasis of pregnancy and impetigo herpetiformis are not real pregnancy-specific dermatoses but they are important to know considering the fetal and maternal risks. Polymorphic eruption of pregnancy is a pruritic disease that usually occurs in primiparous women during the last trimester of pregnancy. Atopic eczema of pregnancy is still controversial as an entity covering conditions with eczematous lesions, prurigo, or folliculitis, and inconstantly associated with a personal history of atopy. Skin biopsy with direct immunofluorescence or search for serum anti-BPAg1 (180kD) NC16a antibodies is mandatory in pruritic dermatoses of pregnancy in order to rule out pemphigoid gestationis. Serum bile salts levels should be tested whenever a generalized pruritus develops during pregnancy in order to rule out intrahepatic cholestasis.
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PMID:[Pregnancy-specific dermatoses]. 2519 21

Pruritic urticarial papules and plaques of pregnancy (PUPPP) is one of the most common diseases associated with pregnancy. In most cases, the skin lesions develop in the third trimester of primigravidas. There are no systemic alterations seen in PUPPP; however, most patients report severe pruritus. A 34-year-old woman presented 1 week postpartum with typical clinical features of PUPPP. The patient showed good response to intramuscular injection of autologous whole blood with no adverse effects to the patient or her baby. Presentation of PUPPP in the postpartum period is rare. Conservative management with topical corticosteroids and oral antihistamines is commonly used to relieve pruritus. In severe cases, skin lesions and symptoms are controlled with a brief course of systemic corticosteroids. Investigation of new treatment options has been limited by patient concerns about the negative effects of medication on the fetus or breastfeeding. Intramuscular injection of autologous whole blood could be an alternative treatment option for PUPPP, especially for women who worry about the use of medications during pregnancy or breastfeeding.
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PMID:Pruritic Urticarial Papules and Plaques of Pregnancy Occurring Postpartum Treated with Intramuscular Injection of Autologous Whole Blood. 2855 15