Dear Ingrid,
This is from a reference book, "Gabbe: Obstetrics - Normal and Problem Pregnancies, 3rd ed.", Copyright © 1996 Churchill Livingstone, Inc.
"PUPPP is the most common dermatosis of pregnancy, but the etiology and pathogenesis are unknown. [19] No hormonal or autoimmune abnormalities have been found in women with PUPPP. [30] Since the majority of women affected by PUPPP are primigravidae with prominent striae or have uterine distention with twins or hydramnios, it has been hypothesized that increased skin tension resulting in skin damage may play a role in the etiology of PUPPP. [12]
The lesions of PUPPP typically begin on the abdomen and initially consist of 1 to 2 mm erythematous papules surrounded by a narrow pale halo that coalesce into urticarial plaques. [31] Small vesicles can also develop on the plaques. They usually spread to the thighs and possibly the buttocks and arms within 2 to 3 days. In contrast to herpes gestationis, the periumbilical area is uninvolved in PUPPP. The face is not affected. Most patients complain of intense pruritus that improves rapidly following delivery with resolution in 1 to 2 weeks. The average onset of the skin lesions is 36 weeks' gestation, and PUPPP rarely develops postpartum (Fig. 37-2) . "
I found this through MDConsult.com which was mentioned in another post. Of course, this is only one reference, but it brings up some interesting points. First, that it is rarely seen postpartum, usually clearing up within 2 weeks of the birth. Also, that noone knows what causes it and it has not been shown to be hormonal. If you read more on this, there are several syndromes with very similar symptoms to PUPPP and it is sometimes difficult to differentiate between them. Suggest that mom do some more research on this before taking the drastic step of weaning. Hopefully some of our MD members will reply with some first-hand knowledge of this condition.
Warmly,
Sharon Knorr, BSMT, ASCP, IBCLC
Newark, NY (near Rochester on Lake Ontario)
mailto:[log in to unmask]
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