A review of literature of polymorphic eruption of pregnancy

<p class="abstract">Polymorphic eruption of pregnancy (PEP), also known as pruritic urticarial papules and plaques of pregnancy [PUPPP] is the most common of all the specific dermatoses of pregnancy. It is a benign, self-resolving, pruritic disorder of pregnancy, usually affecting primigravida during the last trimester of pregnancy or immediately postpartum. Its exact pathogenesis is still unknown, and its clinical presentations are variable. It may mimic many common dermatoses. In PEP, the histological findings are non-contributory and the laboratory results, including direct and indirect immunofluorescence are negative. Diagnosis mainly depends on clinical findings. Significant diagnostic confusion may occur with early lesions of pemphigoid gestationis, which needs to be differentiated from PEP as the former may have a bad fetal outcome. PEP is not associated with any fetal or maternal risk, and symptomatic treatment is all that is usually required. The awareness of this condition helps the physician recognize this entity, reassure the patient, and avoid unnecessary investigations. This review focuses on etiology, various clinical presentations, differential diagnosis, and management of PEP.</p>

Dermatoses Of Pregnancy: A Retrospective Cohort Study In Spain

Background: Dermatoses of pregnancy (DP) is a heterogeneous group of pruritic inflammatory dermatoses that occur exclusively during pregnancy and/or puerperium. The objective of this study was to assess the specific DP and non-specific dermatoses in a Mediterranean population living in Spain. Methods: This five-year retrospective study included 79 pregnant women with dermatologic disease from a total of 10533 pregnancies. Obstetric and clinical variables were assessed. Physiological skin changes of pregnancy were excluded. Those dermatoses that may also be observed beyond pregnancy and puerperium were also excluded. Results: The mean age was 32 years. The most common DP were: Polymorphic eruption of pregnancy (PEP) – 36%, Atopic eruption of pregnancy (AEP) – 26%, Intrahepatic cholestasis of pregnancy (ICP) – 8% and Pemphigoid gestationis (PG) – 6%. The other 24% presented non-specific dermatoses. Only in one case of PG the newborn showed comorbidity. Discussion: Multiple gestations were observed in 10,3% of PEP, in association with a rapid abdominal distention. In AEP, there was a predominance of nulliparous women in the second trimester of pregnancy, an atopic dermatitis background and female newborns. In PG, there was a majority of nulliparous in the second and third trimesters. PG was the only dermatoses associated to comorbidity of the newborn. In ICP, all patients had pruritus in the palms along with excoriations, with predominance of nulliparous and multiple gestations.

Targetoid form of polymorphic eruption of pregnancy: A case report

Polymorphic eruption of pregnancy, formerly known as pruritic and urticarial papules and plaques of pregnancy, is an uncommon cutaneous eruption that can affect women during their third trimester of pregnancy. As its name implies, it has a variety of morphologies and it is important to consider other diagnoses, such as pemphigoid gestationis, which polymorphic eruption of pregnancy can mimic. Sometimes, as in this case, polymorphic eruption of pregnancy can have a targetoid morphology reminiscent of erythema multiforme. A thorough workup and conservative management plan helps reassure the patient that the correct approach is being taken during the challenging period of a pregnancy nearing completion.