itchy skin in pregnancy can be PUPPP
Not all itchy rashes are eczema or food related. Sometimes itchy pregnancy related rashes may mimic eczema .Sometimes there are conditions such as pregnancy where rashes are more common especially in the last trimester (or second trimester as well) and also may be more common in first time pregnancies (primigravida pregnancies ) or in multiple pregnancies. The rash is often presenting with papules or plaques and can present over the anterior abdominal wall and onto the legs and sometime the arms. This condition is known as PUPPP pruritic and urticarial papules and plaques of pregnancy . The face is often spared and the belly button is also spared.
The incidence is about 1 in every 200 cases of pregnancy. It is a chronic hives like rash that affects women in pregnancy .
In most cases PUPPP resolves spontaneously about a week after delivery and it is harmless to the mom and unborn child although can be distressing because of the itch. As in the case of a patient that presented to me some are concerned about food allergy and once they have the diagnosis of PUPPP they are relieved and reassured and can continue with normal life. In certain cases a topical corticosteroid can be applied with an emollient to relieve the itch. An antihistamine may also be prescribed but the topical therapy is often more effective.
the cause of the eruption is unknown and seems to be more common in women carrying boys.
Other causes of itch in pregnancy include atopic eczema. This is largely hereditary and may become worse or sometimes better during pregnancy . It is more common in patients suffering from other allergies such as athena , allergies and food allergies as well. Limit contact with certain external irritants including wool and pet dander and perfumes. Treatment involves frequent use of suitable emollients such as epimax or e45 and in some cases mild / moderate topical corticosteroids combined with emolients. Stress may exacerbate eczema .
