PUPP syndrome in pregnancy | PUPP Syndrome

PUPP syndrome in pregnancy

The PUPP syndrome always occurs during pregnancy. Non-pregnant women are never affected by this itchy rash. The rash usually appears at the beginning of the second half of pregnancy and starts on the abdomen and trunk.

As the pregnancy progresses, the rash spreads towards the arms, while the rash on the abdomen already begins to heal. During pregnancy there may also be several attacks in different parts of the body, which may also be of varying intensity. In some cases, PUPP syndrome is very mild and treatment is not necessary.

If the PUPP syndrome is very severe, it may be necessary to take cortisone ointments and also so-called antihistamines, which are normally used for allergies such as hay fever. Compared to all pregnant women and the pregnancy-accompanying symptoms, the PUPP syndrome occurs relatively rarely. Only in about 5-7% of all pregnant women there is an indication for a PUPP syndrome. Furthermore, there are some other dermatoses that can occur independently of a PUPP syndrome. Here, depending on the cause, either a treatment indication or a wait-and-see attitude can be decided upon.

PUPP syndrome after birth

In most cases, PUPP syndrome begins with the beginning of the second half of pregnancy. In some exceptional cases, pregnant women suffer earlier from the agonizing itching and the typical skin symptoms. It is interesting that almost all PUPP syndromes heal immediately after pregnancy.

This happens already a few days after birth, which makes a certain connection with the hormonal balance of the woman likely. In a few cases, the itching and reddening of the skin persists even after the birth. In this case, it is indeed advisable to repeat the diagnosis in order to identify other factors that trigger this rash.

PUPP syndrome during lactation

The onset of PUPP syndrome usually occurs at the beginning of the second half of pregnancy. Shortly after birth, 95% of the symptoms have already disappeared and the skin disease has healed. Thus, one can expect an average duration of the disease of 4.5 months.

In the worst case, however, the disease starts shortly after the beginning of pregnancy and continues until shortly after birth. So it can also happen that the duration of illness and treatment is more than 9 months. If the duration of the illness is very long, other causes should always be excluded.

For example, every patient suffering from a skin rash typical for a PUPP syndrome should also have a large blood count taken to see whether it is possibly an infection-related cause. Sometimes, even in the second half of pregnancy, a slight skin involvement of several weeks may be present. The skin reddens and itches slightly, also begins to flake, but then heals after a few weeks. Why it comes in some cases to a stronger and sometimes to a weaker course, is as unknown as the actual cause of the PUPP syndrome.