Pruritic urticarial papules and plaques of pregnancy: Clinical and immunopathologic observations in 57 patients☆,☆☆
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PATIENTS AND METHODS
Between 1979 and 1990, 57 patients with the diagnosis of PUPPP were seen. Timing of onset, distribution of lesions, specific clinical appearance, and medical and drug history were noted.
Specific inquiry was made into the use of antibiotics in the month before onset of eruption. Several patients were excluded from the PUPPP diagnosis group because they had used antibiotics in the weeks preceding the eruption.
After informed consent was obtained, lesional skin biopsy specimens were obtained in 48
Onset
The average age of the patients at onset was 25.4 years (range, 16 to 40 years). Twenty four (42%) of the 57 patients were primagravidas, 16 (28%) were gravida 2, 9 (16%) gravida 3, 4 (7%) gravida 4, 3 (5%) gravida 6, and 1 (1.7%) gravida 7; 68% of the patients were nulliparous. Gestational age at the time of onset of eruption showed variability (Table I); onset occurred in the first and second trimester, as well as in the third. Forty-five of the patients (79%) were in the third trimester, but
DISCUSSION
The most commonly diagnosed pruritic dermatosis of pregnancy is one that presents us with a confusing array of nomenclature and an unknown pathogenetic mechanism. The confusion is created by the broad clinical spectrum and diversity of the cutaneous features. A parallel disease in pregnancy with a wide clinical spectrum and morphologic diversity occurs in HG, but this disease has an identifiable common denominator. A linear band of complement (C3) is always present on DIF examination of
References (42)
- et al.
The specific dermatoses of pregnancy
J Am Acad Dermatol
(1983) - et al.
J Am Acad Dermatol
(1984) - et al.
Pruritic urticarial papules and plaques of pregnancy (PUPPP)
J Am Acad Dermatol
(1981) - et al.
Hormonal evaluation and autoimmune background in PUPPP
Am J Obstet Gynecol
(1988) - et al.
Facial involvement in pruritic urticarial papules and plaques of pregnancy
J Am Acad Dermatol
(1986) Facial involvement in pruritic urticarial papules and plaques of pregnancy
J Am Acad Dermatol
(1987)- et al.
Familial occurrence of pruritic urticarial papules and plaques of pregnancy
J Am Acad Dermatol
(1992) - et al.
Pruritic urticarial papules and plaques of pregnancy: a severe case requiring early delivery for relief of symptoms
J Am Acad Dermatol
(1992) Herpes gestationis
J Am Acad Dermatol
(1987)- et al.
Linear IgM dermatosis of pregnancy
J Am Acad Dermatol
(1988)
Toxemic rash of pregnancy
Proc R Soc Med
Prurigo of pregnancy
Aust J Dermatol
Prurigo of late pregnancy
Aust J Dermatol
Pruritic urticarial papules and plaques of pregnancy
JAMA
A comparative study of toxic erythema of pregnancy and herpes gestationis
Br J Dermatol
The specific dermatoses of pregnancy; a reappraisal with specific emphasis on a proposed simplified clinical classification
Clin Exp Dermatol
Pruritic urticarial papules and plaques of pregnancy
J Reprod Med
Late prurigo of pregnancy
Br J Dermatol
Pruritic urticarial papules and plaques of pregnancy
Cutis
Pruritic urticarial papules and plaques of pregnancy (PUPPP)
Acta Derm Venereol (Stockh)
Pruritic urticarial papules and plaques of pregnancy
Arch Dermatol
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Reprint requests: Iris K. Aronson, MD, Department of Dermatology, M/C 624, University of Illinois, College of Medicine, 376 CME, 808 S Wood St, Chicago, IL 60612.
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