Pupps Rash in Pregnancy

Pupps rash is a persistent disorder that tends to affect pregnant women and leads to the formation of hives on the surface of the skin. The medical term for the disease is Pruritic Urticarial Papules and Plaques of Pregnancy or PUPPP. It is also referred to as Polymorphic Eruption of Pregnancy or PEP in the United Kingdom.

Pupps rash results in extreme itchiness as well as a lot of discomfort for the expectant woman. However, it does not result in the development of long-term or permanent damage to the child or the mother. Pupps rash often starts on the stomach and then migrates to the other body parts such as the arms, chest, feet, legs, and neck.

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Symptoms of pupps rash

A few signs and symptoms of pupps rash are listed below:

  • There are two forms of pupps rash. The first kind may appear in the form of lumps or papules on the skin, while the second type may result in skin anomalies such as lesions, blisters, lumps, etc. Most cases of pupps rash get cured with the passage of time.
  • Women affected by pupps rash may also develop multiple types of rashes. These polymorphic rashes may give rise to blisters in addition to lesions and increased redness of the skin. Such skin abnormalities are similar to eczema rashes.
  • Normally, a majority of pupps rash cases appear in the form of elevations or firm lumps on the skin surface. They are called papules and can result in intense itchiness. Besides this, about fifty percent of pupps rash affected women do not develop any other complication.
  • Women who are carrying heavy babies, twins, or triplets tend to experience extensive stretching and abdominal skin distention. These stretched sections of skin are the first areas to develop pupps rash.
  • Pupps rash initially affects the abdominal area. The belly button remains unaffected. The rashes can however spread to other areas like the neck, feet, the under arms, breasts, and legs. Pupps rash does not affect the face.
  • On an average, pupps span tends to last for about six weeks. The rashes disappear on their own within two weeks of childbirth. Severely itchy cases of pupps rash may last for a week.

Causes of pupps rash

There are no known causes of pupps rash. Different studies have not found any relation between the disease and the presence of autoimmune abnormalities, hormonal disruptions, or fetal disorders. However, the below mentioned facts indicate the varied risk factors that increase the chances of developing pupps rash:

  • A majority of pupps rash cases have been found to be caused by excessive stretching of the abdominal skin. Hence, women who have become pregnant for the first time are at greater risk to developing a case of pupps rash during the third trimester.
  • A few studies have shown that expectant mothers who develop pupps rash often tend to give birth to a male child. The varied biopsies of the rash bumps or papules have revealed that they contain male fetal DNA, thereby leading to a possible conclusion that male fetal DNA increases the likelihood of developing skin abnormalities.
  • It may also be noted that women who are carrying twins, triplets, or very large babies are more likely to develop a case of pupps rash as opposed to other mothers who are pregnant with a single baby that is of normal size and weight.

There are no specific tests which aid in the diagnosis of pupps rash. One can only determine its presence by the appearance of papules during pregnancy.

Pupps rash does not result in complications for the baby or the mother. However, in some cases the affected women may experience high blood pressure or induced labor.

Treatment of pupps rash

A case of pupps rash may be treated in the following ways:

  • The application of water based creams, moisturizing creams and other such topical emollients can aid the treatment of mild instances of pupps rash
  • Application of class I or class II corticosteroid topical ointments can help in the treatment of moderate instances of pupps rash
  • Expectant mothers who are suffering from severe instances of pupps rash may need to intake oral corticosteroids. However, these medicines can result in harmful side effects for the unborn child and the mother. Hence, these medications should only be consumed after thorough consultation with a doctor and after checking other alternative treatment options.
  • Persistent and discomforting cases of pupps rash may be prevented by undergoing induced labor after 37 weeks of pregnancy
  • Intense itchiness associated with pupps rash can be alleviated with antihistamine medications. However, these drugs are not as effective as corticosteroid therapy
  • A majority of pupps rash cases tend to fade away on their own post delivery of the child. However, if pupps rash continues to persist even two weeks after delivery, then the patient should seek medical attention.

Pupps Rash Pictures


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