While most women go through their pregnancy with relatively few complications, one in 160 to 240 women will experience pruritic urticarial papules and plaques of pregnancy (PUPPS). PUPPS rash and pregnancy hormones are not directly related though the rash only develops during pregnancy. The second most common dermatological issue of pregnancy (after atopic eruption of pregnancy) PUPPS normally occurs in 73% of primigravidae (first-time) pregnancies during the third trimester (around 35 weeks) with 11.7% of women who are affected by PUPPS having multi-gestational pregnancies. PUPPS rash and pregnancy dermatological issues should be discussed with a doctor in order to properly diagnose and prescribe an appropriate treatment plan. While most dermatology issues during pregnancy are mere irritants, more severe disorders and illnesses can manifest on the skin making a doctor’s visit important.
PUPPS Rash and Pregnancy – Symptoms
PUPPS usually appears in stretch marks (striae) on the belly near the bellybutton, though the bellybutton is not the cause. Small, red, swollen bumps begin to appear in the skin of the stretch mark, increasing in size until they form larger bumps on the whole of the abdomen. Within a couple of days more severe cases will spread to the lower body, chest, breasts, and arms and may include small blisters. Fortunately, the rash does not spread to the face. PUPPS-related health threats to mother and child are nonexistent, with no side effects caused by the rash. However it is very itchy (pruritic) and can be annoying, causing increased discomfort through the most difficult final weeks of pregnancy. The most intense itching is usually within the first week of the rash, clearing entirely in an average of six weeks and/or after giving birth.
PUPPS Rash and Pregnancy – Cause
The exact cause of PUPPS is unknown. What is known is that it is not a form of autoimmune disorder, hormones, fetal abnormalities, or preeclampsia. There is a statistical correlation between multi-gestational pregnancies and PUPPS. According to Medscape Reference (http://emedicine.medscape.com/article/1123725-overview), of the 11.7% of women with multi-gestational pregnancy and PUPPS, those with triplets (14%) are more likely to develop PUPPS than those with twins (2.9%). One suggestion is that the growth of the belly and subsequent stretch marks cause the body to react with an inflammatory response. There has also been an observed increase in weight gain (leading to stretch marks) of patients with PUPPS versus other pregnancies, which further supports the idea that the skin distension plays a factor in PUPPS development. While approximately 90% of women will development stretch marks during pregnancy they are not an automatic indicator that you will develop PUPPS or another complication.
