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Pruritic Urticarial Papules and Plaques of Pregnancy

By Antonette T. Dulay, MD, Attending Physician, Maternal-Fetal Medicine Section, Department of Obstetrics and Gynecology;Senior Physician, Main Line Health System;Axia Women’s Health

Pruritic urticarial papules and plaques of pregnancy are intensely itchy rashes that occur only during pregnancy.

Pruritic urticarial papules and plaques of pregnancy is common. 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. 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 and does not recur during subsequent pregnancies.

Doctors may have difficulty making a definite diagnosis.

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.

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