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PUPPPPruritic Urticarial Papules and Plaques of Pregnancy
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At this stage, it is very difficult to distinguish this disease from PUPPP.
Direct immunofluorescence (DIF) is the most sensitive and specific assay for differentiating PG from PUPPP.
FIGURE 3: GRAVIDITY DISTRIBUTION OF SPECIFIC DERMATOSIS Primi Multi Pruritus 2 2 Prurigo 4 8 PUPPP 1 1 Specific dermatoses of pregnancy Note: Table made from bar graph.
As the name suggests, the lesions of PUPPP are itchy, red papules that often coalesce into plaques (FIGURE 2, page 28).
This distribution helps to differentiate PUPPP from PG, where the lesions typically cluster around the umbilicus.
Women with PUPPP also may have vesicles (up to 40%) and erythema multiforme--like lesions (up to 20%).