PUPPP: Pruritic Urticarial Papules and Plaques of Pregnancy

Most women feel some form of discomfort during pregnancy and many find that the skin feels more itchy and dry than before. However, for some women extreme itchiness occurs and is part of a medical condition called Pruritic Urticarial Papules and Plaques of Pregnancy (PUPPP) also known as polymorphic eruption of pregnancy. Fortunately PUPPP is a condition that is harmless to both mother and baby, but it is very uncomfortable for an expectant mother.

Symptoms
PUPPP usually begins in the middle of the third trimester but can occur earlier. It starts with a rash on the mother's abdomen, usually on or near stretch marks. Within a few days, the rash spreads outward to the rest of the abdomen, buttocks, thighs, breasts and arms. The rash is extremely itchy and is similar in appearance to hives. PUPPP is most common for first time mothers.

Causes
The cause of PUPPP is not known but some medical professionals believe that it may be caused by male fetal DNA. Over 70 percent of women with PUPPP give birth to boys and in one study male fetal DNA was found in the skin biopsies of those suffering with the rash.

Diagnosis
Obstetricians and Dermatologists diagnose PUPPP simply by looking at the skin and listening to the pregnant mother's description of her symptoms. No invasive tests are needed but a biopsy may be done if there is a question of the diagnosis.

Medical Treatment
High strength steroid creams are used for an initial treatment of PUPPP. Once the rash is under control, many mothers switch to a lower strength steroid cream for the duration of pregnancy. Mothers with severe cases may need to take a daily oral steroid. Since the itch can keep a pregnant mother awake at night, benadryl or another antihistamine is often suggested although antihistamines are not effective in getting rid of the rash.

Alternative Treatment
Dandelion Root herb has been used to treat PUPPP and has a reputation for nourishing the liver, which can be helpful when suffering from a rash such as PUPPP. It's important to note that Dandelion Root, like most herbal treatments are not approved by the FDA although midwives and herbalists have been using this remedy for hundreds of years. Acupuncture is also helpful in relieving the symptoms of PUPPP but should be performed by a certified acupuncturist. Minor cases of PUPPP may find relief with use of oatmeal baths, ice packs and specialized lotions and soaps.

http://dermatology.about.com/cs/pregnancy/a/puppp.htm

http://pregnancychildbirth.suite101.com/article.cfm/puppps_pregnancy_skin_rash