From the Guidelines
Pemphigus, atopic eruption of pregnancy, polymorphic eruption of pregnancy, and pemphigoid gestationis are types of dermatological rashes that can occur during pregnancy, with atopic eruption of pregnancy being the most common pruritic disorder of pregnancy. The most common pregnancy-specific rashes include pruritic urticarial papules and plaques of pregnancy (PUPPP), intrahepatic cholestasis of pregnancy, pemphigoid gestationis, and atopic eruption of pregnancy, which is associated with an eczematous rash on the face, eyelids, neck, antecubital and popliteal fossae, trunk 1. Some of these rashes, such as pemphigus, are rare and require close cooperation between dermatologist, obstetrician, and neonatologist, as well as careful selection and monitoring of immunosuppression during pregnancy 1. Key characteristics of these rashes include:
- PUPPP: itchy, red bumps that start on stretch marks of the abdomen and may spread to the thighs and arms
- Intrahepatic cholestasis of pregnancy: intense itching without a visible rash, primarily on the palms and soles
- Pemphigoid gestationis: rare autoimmune blistering rash that begins around the navel and spreads
- Atopic eruption of pregnancy: eczema that worsens during pregnancy, associated with an eczematous rash on the face, eyelids, neck, antecubital and popliteal fossae, trunk Treatment for these rashes typically includes topical corticosteroids, oral antihistamines, and moisturizers for mild symptoms, and prescription-strength medications under medical supervision for severe cases 1. It is essential to evaluate any new rash during pregnancy by a healthcare provider to rule out more serious conditions, as some of these rashes can have significant implications for the mother and the fetus, such as an increased risk of fetal morbidity with gestational pemphigus vulgaris 1.
From the Research
Dermatological Rash during Pregnancy
- The most common dermatological rash that occurs during pregnancy is Pruritic Urticarial Papules and Plaques of Pregnancy (PUPPP) 2, 3, 4.
- PUPPP is a benign, self-limited skin disorder that typically affects primigravidas in their third trimester of pregnancy 3, 4.
- The clinical features of PUPPP include pruritic urticarial papules and plaques, which mainly affect the abdomen and proximal thighs 4.
- PUPPP is associated with multiple gestation pregnancies, and its pathogenesis remains elusive 3.
- Treatment of PUPPP is largely symptomatic, and topical corticosteroids, such as fluticasone propionate lotion, have been shown to be effective in resolving the condition 2.
- Oral antihistamines and emollients may also be used to control symptoms of PUPPP 4.
- In some cases, a short course of oral prednisone may be necessary to induce remission of the disease 5.
- However, it is essential to be aware of the potential side effects of steroids, which can occur even at low doses 6.