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Subject:
From:
Darlene A Breed <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Thu, 24 Apr 1997 01:23:35 EDT
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This is the information I found in Current Obstetric & Gynecologic
Diagnosis & Treatment, hope it helps:
"Pruritic Urticaria Papules & Plaques of Pregnancy (puppp)
This is a rare syndrome of red, pruritic papules principally on the
abdomen and thighs without excoriations.  The lesions usually occur late
in pregnancy and disappear within two weeks after delivery.  In many, a
marked halo surrounds the small papules and plaques.  Focal lesions are
rare, and they are never on the face or distal extremities.  There are no
abnormal hCG levels and immunoflorescence reveals no immunoglobulin
complement.  Symptomatic treatment and occasionally corticosteroid
therapy are curative in resistant cases.
Herpes Gestationis
This uncommon (2-3:10,000 gestations) eruption appears in the second and
third trimester of pregnancy.  It features erythematous plaques with
vesicles that soon form bullae in the periphery of the lesion.  Because
it is a blistering eruption, it has a herpetiform appearance, but the
vesicles are not clustered and are more peripheral.  Lesions usually
begin on the trunk and spread to the entire body, including the distal
extremities.  Lesions on mucous membranes are uncommon. ..the course is
characterized by exacerbations and remissions during pregnancy.  While
significant exacerbations can occur postpartum, the condition usually
abates by the sixth week.
Although its cause is not known, it is suspected to be related to hormone
levels, since progestins can produce exacerbations.
The course of herpes gestationis in subsequent pregnancies is not
predictable.  Corticosteroids are the treatment of choice.
Darlene Breed RN BSN IBCLC

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