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PUPPPPruritic Urticarial Papules and Plaques of Pregnancy
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A bit higher percentage has been reported by other authors.8,13 PUPPP was the commonest specific disorder of pregnancy accounting for 5.6% followed by prurigo of pregnancy in 12 (3.5%) cases and pruritus gravidarum (also known as intrahepatic cholestasis of pregnancy) in 4 (1.2%) cases.
At this stage, it is very difficult to distinguish this disease from PUPPP. The lesions then progress to a generalized bullous eruption that usually spares the mucous membranes, palms and soles.40
Direct immunofluorescence (DIF) is the most sensitive and specific assay for differentiating PG from PUPPP. Performed on perilesional skin, DIF shows a linear band of C3 and/ or IgG at the basement membrane.
A second reason is that many names were given to the same disorder--"a primary example is PUPPP [pruritic urticarial papules and plaques of pregnancy]," Dr.
Newborn and soles may be small for gestational age, but no associated morbidity or mortality PUPPP (8-10) Urticarial papules Usually present after and plaques on 34th week, but can abdomen, legs, arms, present at any stage.
Initially, PUPPP lesions can be difficult to differentiate from urticarial PG lesions.
Of these the most common was prurigo of pregnancy (12%) followed by pruritus of pregnancy (4%), PUPPP (2%).
of cases & Percentage (%) Pruritus of pregnancy 12 (4.00) Prurigo of pregnancy 36 (12.00) Polymorphic eruption 6 (2.00) of pregnancy (PUPPP) * Prurigo of pregnancy was common specific dermatoses (12%) followed by Pruritus of pregnancy (4%).
(2) Pruitic urticarial papules and plaques of pregnancy This condition is known by many names besides its acronym PUPPP: polymorphic eruption of pregnancy, toxemic erythema of pregnancy, and late prurigo of pregnancy.
The first attempt to classify these conditions was made by Holmes and Black in 1982-83 who classified them into: a) Pemphigoid Gestationis (PG) or Herpes Gestationis(HG), b) Polymorphic Eruption of Pregnancy (PEP) or Pruritic Urticarial Papules and Plaques of Pregnancy (PUPPP), c) Prurigo of Pregnancy (PP) and d) Pruritic Folliculitis of Pregnancy (PF).