>I hate to show my ignorance, but now and again I can't interpret the
>alphabet soup. What is PUPP?

Rowena, It is not your ignorance, but your good luck.  I had to do a search
to find out what it is.  And what a "fun" search it proved to be.  "Search
PUPP in Lactnet."

And I got 77 matches, most of which were about "puppies."  I had no idea
that we had talked about little dogs so much. There were 8 posts on PUPP.
One of the most comprehensive was from Darleen Breed. I'll send it to you.

But a major theme was that it is NOT caused by breastfeeding and weaning is
NOT a credible treatment.

Patricia Gima, IBCLC
Milwaukee, Wisconsin, Upper Midwest, USA
____________

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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