What causes PUPPP?

PUPPP is thought to be related to stretching of the skin on the abdomen. Somehow the rash develops as a sort of "allergy" to the stretch marks and spreads elsewhere on the body.
Supporting the stretch mark theory are the following observations:

-Most cases begin in the last 3 months, especially the last 5 weeks, when the stretching is greatest. It is rare for PUPPP to begin after delivery.

-PUPPP is most common in a first pregnancy, when the abdomen is tightest.

-The rash usually starts around the umbilicus where stretching of the abdomen is greatest.

-On average, patients with PUPPP have greater weight gain, babies that are heavier than normal and an increased chance of having twins.

-Another theory considers low level traffic of fetal cells within the mother's circulation, which appears increased in women with PUPPP and may persist for some time after the baby has been born.


What are the features of PUPPP?

Small, pink, raised spots (papules) appear in the stretch marks around the umbilicus. There is often a pale halo around the papules. These papules coalesce to form large red, raised (urticarial) patches (plaques) which spread to involve the buttocks and thighs, and sometimes the arms and legs. Lesions on or above the breasts are rare.
PUPPP is very itchy (pruritic) and patients find it difficult to sleep at night.


Does PUPPP affect the baby?

Rarely, the baby can be born with a mild PUPPP rash but this soon fades. PUPPP does not cause any other problem with the baby.


How long does PUPPP last?

PUPPP continues until delivery then usually resolves within a few weeks. Rarely, it may persist for longer. In some cases, this relates to retained placental products.


Treatment

There is no curative treatment for PUPPP (apart from delivery!). Symptoms can be controlled using:
Emollients (moisturisers) applied liberally and frequently as required.
Topical steroids applied thinly twice daily to the red itchy patches.
Antihistamines - conventional antihistamine tablets appear safe in late pregnancy (though they may make the baby drowsy on delivery).
Discuss your treatment with your doctor, or ask to be referred to a dermatologist.


Can PUPPP recur with future pregnancies?

This is very uncommon. If it occurs the PUPPP is likely to be milder.


What is PUPPP and how is it dealt with?

While you are pregnant, your body's chemistry ebbs and flows, mostly working for the benefit of your health and the health of your baby. One of the less beneficial side-effects of pregnancy can be skin changes, such as PUPPP.

PUPPP stands for Pruritic Urticarial Papules and Plaques of Pregnancy. It is a common rash that most often appears in the first pregnancy during the 3rd trimester. Typically, PUPPP does not affect pregnancies after the first. PUPPP typically begins in the stretch mark area of the abdomen. It does not involve the belly button. The rash consists of small red swollen spots inside the stretch mark that grow together to form larger spots over the abdomen. The rash can spread to the thighs, buttocks, breasts and arms.

The cause of PUPPP is not known. Statistics show that 70% of women with PUPPP give birth to boys, so there is some theory that suggests that the male fetal DNA acts as a skin irritant.
The diagnosis of PUPPP is based solely on the appearance of the rash. There are no laboratory tests necessary to detect PUPPP. Skin biopsies are not generally performed unless there is a question about the diagnosis.

PUPPP cannot be cured, but the symptoms can be dealt with. High strength steroid creams or ointments used up to 5 to 6 times a day usually relieve the itching and prevent the spread of the rash. Once the rash is under control, changing to a lower strength steroid used less frequently is advisable. For severe cases, daily oral steroids may be necessary to control itching. Oral antihistamines are generally less effective for itching than steroids, but may be useful at night to help with sleep. PUPPP will disappear once the baby is delivered.




How annoying is this! Pregnant women already go through so much... why the hell do we have to get this too! Fucken hell!!!!!