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Pruritic Urticarial Papules and Plaques of Pregnancy

By

Antonette T. Dulay

, MD, Main Line Health System

Last full review/revision Oct 2020| Content last modified Oct 2020
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Pruritic urticarial papules and plaques of pregnancy are intensely itchy rashes that occur only during pregnancy.

Pregnancy complications, such as pruritic urticarial papules and plaques of pregnancy, are problems that occur only during pregnancy. They may affect the woman, the fetus, or both and may occur at different times during the pregnancy. However, most pregnancy complications can be effectively treated.

Pruritic urticarial papules and plaques of pregnancy occurs in about 1 in 160 to 300 pregnancies. It is much more common among woman who are carrying more than one fetus (multiple births). This rash usually occurs in a first pregnancy. The cause is unknown.

Red, irregularly shaped, slightly raised patches appear on the abdomen. The patches sometimes have tiny fluid-filled blisters in the center. Often, the skin around them is pale. The rash spreads to the thighs, buttocks, and occasionally the arms. The palms, soles, and face are usually not affected. Hundreds of itchy patches may develop. Itching is bothersome enough to keep the woman awake at night.

Typically, the rash appears during the last 2 to 3 weeks of pregnancy and occasionally during the last few days or after delivery. However, it may occur at any time after the 24th week. Usually, the rash clears up promptly after delivery. It recurs in up to 5% of subsequent pregnancies.

Doctors base the diagnosis of pruritic urticarial papules and plaques of pregnancy on symptoms. However, making a definite diagnosis may be difficult because it resembles other itchy rashes.

Applying a corticosteroid cream (such as triamcinolone) directly to the skin often helps. Rarely, for severe symptoms, a corticosteroid (such as prednisone) is given by mouth.

Antihistamines that do not cause drowsiness, taken by mouth, can also be used to relieve the itching.

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