Pruritic urticarial papules and plaques of pregnancy: An unusual case report from a tertiary care hospital of the Eastern part of India

Soumyadeep Mahapatra, Anindita Maiti
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Abstract

Pruritic urticarial papules and plaques of pregnancy (PUPPP) is a rare dermatitis of unknown etiology first diagnosed in 1979. It occurs most commonly in the 3rd trimester of pregnancy. Postpartum presentation is extremely rare. Treatment modalities mostly involve the relief of symptoms. We are going to report here one case of a 24-year-old primigravid female who presented in the 9th month of the gestational period with generalized pruritic eruptions in a tertiary care hospital in the Eastern part of India. These eruptions were erythematous, hyperpigmented, and papular, which began within the striae distensae of the abdomen and progressively spread on the skin of upper and lower limbs, trunk, and buttocks. After the delivery of a full-term male child, there was an aggravation of the symptoms such as itching and disturbed sleep. There was also increased spread of the lesions over the skins of the mentioned areas, which persisted for 6 weeks of the postpartum period. The lesions and associated symptoms gradually subsided with topical application of corticosteroids and hydroquinone along with oral antihistaminic for prolonged periods. Our objective behind reporting this case is to make clinicians aware of PUPPP as a differential diagnosis of peripartum and postpartum pruritic eruptions for prolonged periods.
妊娠期瘙痒性荨麻疹丘疹和斑块:印度东部一家三级医院的罕见病例报告
妊娠瘙痒性荨麻疹丘疹和斑块(PUPPP)是一种罕见的皮炎,病因不明,1979 年首次确诊。它最常见于妊娠期的第三个月。产后发病极为罕见。治疗方法主要是缓解症状。我们将在此报告一例 24 岁初产妇的病例,她在妊娠期第 9 个月出现全身瘙痒性疹子,就诊于印度东部的一家三级医院。这些疹子呈红斑、色素沉着和丘疹状,从腹部的条纹开始,逐渐扩散到上下肢、躯干和臀部皮肤。一名足月男婴出生后,瘙痒和睡眠不安等症状加重。皮损在上述部位的扩散也有所增加,并在产后持续了 6 周。在局部使用皮质类固醇激素和氢醌以及长期口服抗组胺药后,皮损和相关症状逐渐消退。我们报告该病例的目的是让临床医生认识到,PUPPP 是围产期和产后长期瘙痒症的鉴别诊断之一。
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