Pregnancy

Pregnancy may be associated with pruritus, in which the skin appears normal in 15-20% of women (prunigo gestationis). It is generally more severe in the first trimester.

Polymorphic eruptions also present with pruritis with urticaria papules and plaques (the PUPP syndrome). It usually occurs on the abdomen in the third trimester and then becomes widespread. There may be a postpartum flare up. It can be a distressing condition for the mother but the baby is not affected, and it rarely recurs in subsequent pregnancies. Topical steroids can be used, but systemic steroids should be avoided.

Pemphigoid gestationis is a rare disorder that may resemble PUPP initially but develops pemphigoid-like vesicles, spreading over the abdomen and thighs: autoantibodies to the basement membrane are present.

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