Pruritic Urticarial Papules and Plaques of Pregnancy or PUPPP, a form of itching that can occur during pregnancy. The skin looks red, itches very much and this is almost always accompanied by hives (urticaria). Approximately how many pregnant women are affected by PUPPP? What causes the itching and what are the treatment options? Can the complaints return during a subsequent pregnancy? Does PUPPP influence the course of pregnancy? And on the baby?
Article content
- Itch
- PUPPP
- Who affects PUPPP?
- Cause and influence on the course of pregnancy and baby
- Symptoms
- Diagnosis
- Therapy
- What can you do yourself?
- Prognosis
Itch
Itching is also called pruritus . It is a phenomenon that occurs when certain nerve endings are stimulated just under the skin. Itching occurs with many skin diseases such as eczema, fungal diseases, lichen ruber planus. Also in case of childhood diseases (particularly chickenpox), excessive sunbathing, diabetes mellitus, a disorder of the thyroid gland. Jaundice is also often accompanied by itching.
PUPPP
PUPPP stands for Pruritic Urticarial Papules and Plaques of Pregnancy . It is also called Polymorphic eruption of pregnancy. These are red bumps that itch or red plaques on the skin of the abdomen. It can also spread to other parts of the body such as arms, thighs, buttocks, breasts. The early form of PUPPP is called prurigo gravidarum , which occurs in the second trimester of pregnancy. Prurigo gravidarum involves swellings on the skin, which are usually colorless and itchy.
Who affects PUPPP?
PUPPP occurs in approximately 1 in 250 pregnant women . Usually only with a first pregnancy and not with subsequent pregnancies. PUPPP is more common in multiple pregnancies and rapid weight gain. It occurs in the third trimester and disappears at the end of pregnancy or a few days after the birth of the child.
Cause and influence on the course of pregnancy and baby
not clear what causes PUPPP . There are researchers who suspect that the mother’s skin reacts to certain proteins in the placenta. It is also thought that a rapid increase in weight of the mother and the unborn child influences the development of PUPPP: that the rapid stretching of the wall of the abdomen causes a local inflammatory reaction. You see PUPPP more often in a multiple pregnancy. PUPPP does not affect the pregnancy or the baby.
Symptoms
Red, itchy rash in the last three months of pregnancy. It starts on the abdomen, often with stretch marks around the navel (navel remains free), but can also spread to other parts of the body: buttocks, thighs, breasts, arms. Usually no rash on the face. The rash resembles hives, it can be small bumps but also plaques. During the healing phase, the image is reminiscent of eczema.
Diagnosis
To make the diagnosis, a biopsy of the skin can be taken. Blood tests can also be done. It must be checked whether something else is going on, such as herpes gestationes. Herpes gestationes can look very similar to PUPPP, but with herpes gestationes you see blistering.
Therapy
The doctor can prescribe medication that calms the itching, such as a mild hormone cream or an antihistamine. If it is very serious, a doctor can prescribe a short course of prednisolone. The choice of medication is limited because it must be safe for a pregnant woman. Very occasionally it happens that PUPPP causes the pregnant woman to no longer be able to sleep due to the itching. Then a decision may be made to be admitted to hospital to relax.
What can you do yourself?
Try not to scratch, although it will be very difficult. Scratching only makes the complaints more severe. Menthol gel or menthol powder can reduce the symptoms somewhat. Use almond oil in the bath, this can alleviate the complaints somewhat. But don’t shower or bathe too often, as this can dry out the skin, which can lead to more itching. If you want to lubricate the skin, do not use products with added perfume. When it comes to clothing and bedding, it is best to choose cotton.
Prognosis
The skin abnormalities disappear again after birth. It is possible that someone will suffer from it again during a subsequent pregnancy, but it is not necessary. You see PUPPP occur more often in multiple pregnancies.
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- Itching: what causes it and what can you do about it?
