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Ever heard of PUPP in pregnancy?

July 13, 2010

Try saying this after a night on the tiles, Pruritic Urticarial Papules and Plaques of Pregnancy!  Also known as Polymorphic eruption of pregnancy. In short it is better known as PUPP.

Hand on heart I had NEVER heard of such a thing before my first pregnancy with Little Bean but I soon became acutely aware of it and just how painfully uncomfortable it is.  Apparently it is actually quite a common rash suffered by pregnant women, usually in their first pregnancy during the third trimester with the onset being around 35 weeks.  This is roughly when I started with it.

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To begin with I thought I just had a heat rash as it was such a hot summer but nothing I tried would make it go away.  I literally felt like I had a million tiny ants crawling under my skin and it would become really hot and painful.  Throughout the day I would shower 3-4 times in an effort to cool my skin down and through the night I would attempt to sleep with a wet flannel laid on my bump and a fan blowing directly on me to keep my skin cool.  Each night I took my Nintendo DS to bed with me so that when the itching became too unbearable I could play games to keep my mind and more importantly my hands busy to stop me scratching.

In most cases the rash starts on the abdomen in the stretch marks, though in my case I didn’t actually have any stretch marks until after I had scratched myself until I bled!  Unlike many common rashes in pregnancy it didn’t affect my belly button – this apparently is a distinguishing factor for PUPP. 

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A very severe form of PUPP

Once the rash has taken hold on the abdomen it begins to work its way out of the body by spreading to the thighs, buttocks, breasts and then arms.  It itches like you would not believe but actually it is harmless to both mother and baby.  It lasts for around 6 weeks with the most severe itching lasting around 1-2 weeks (and believe me that is more than long enough).

What causes PUPP?

The cause is unknown, it is not linked to pre-eclampsia, auto-immune disorders, hormonal abnormalities or fetal abnormalities.  It has been suggested that the rapid distension of the abdominal wall can cause damage to connective tissue with an inflammatory response but it is also often associated with women carrying a baby boy and their DNA “clashing”.  Though in my case, I was carrying a baby girl so it is not necessarily the rule. 

How is PUPP treated?

My Doctor treated me with Steroid cream after speaking with a Consultant Dermatologist who confirmed that this would be safe for me to use.  They tried low doses initially but these didn’t seem to have any effect so they increased it to a high strength steroid cream clobetasol (Temovate) or betamethasone (Diplrolene) which could be used 5 or 6 times a day to relieve the itching and prevent it from spreading further. 

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4 Comments leave one →
  1. July 13, 2010 1:11 pm

    I work in an ER-so yes I have seen that before.

    • July 13, 2010 7:55 pm

      Its not fun at all, I’d never heard of it before and neither had my midwife.

  2. Dee permalink
    July 13, 2010 2:25 pm

    I have never heard of it and as a Student Midwife that info will probably come in useful at somepoint! Thanks for sharing. Hope you are well. xx

    • July 13, 2010 7:57 pm

      You’re welcome, even if it helps one person to not suffer longer than necessary then it was worth it! I’m good thanks, just the size of a house and still have 10 weeks growth to go – starting to dread the labour now! xx

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