PUPP!!!

Papulas e Placas Urticarianas Pruriginosas da Gravidez

A explicação em inglês-Pruritic urticarial papules and plaques of pregnancy (PUPPP), also known as polymorphic eruption of pregnancy, is the most common rash in pregnant women. It normally occurs in first pregnancies during the third trimester with an average onset of 35 weeks. Thankfully, PUPPP does not usually affect subsequent pregnancies.

Appearance of PUPPP
The rash of PUPPP almost always begins in the stretch marks (striae) of the abdomen. It does not involve the belly button distinguishing it from other common rashes of pregnancy. The rash itself consists of small, red wheals in the stretch marks that grow together to form larger wheals on the abdomen. Sometimes the rash can include small vesicles. Over the next several days, the rash can spread over the thighs, buttocks, breasts, and arms.

The rash is very itchy, or pruritic, hence the name. This condition is harmless to mother and baby, but can be very annoying. It lasts an average of 6 weeks and resolves spontaneously 1 to 2 weeks after delivery. The most severe itching normally lasts for no more than 1 week.

Cause of PUPPP
The cause of PUPPP is unknown. It is not associated with preeclampsia, autoimmune disorders, hormonal abnormalities, or fetal abnormalities. Some investigators suggest that the rapid abdominal wall distension damages connective tissue and causes an inflammatory response. One study has shown that male fetal DNA can be found in skin biopsies of the rash. Since 70% of women with PUPPP give birth to boys, a new hypothesis is that male fetal DNA acts as a skin irritant.

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