Definition
Under a PUPP (today called PEP), one summarizes so-called polymorphic exanthema in pregnancy. A polymorphic exanthema is a reddish skin irritation of various shapes, which occurs in different parts of the body and can be very itchy. The exact causes usually remain unknown.
The treatment is usually purely symptomatic. The abbreviation is PUPP pruritic urticarial papules and plaques of pregnancy. Translated, this would mean itchy, hives-like papules and plaques during pregnancy.
Causes
The causes for the development of PUPP syndrome are largely unknown. However, most PUPP syndromes are based on the fact that they usually develop in the second half of pregnancy and disappear again immediately after the birth of the child. This fact makes a hormonal involvement likely.
However, there is no proof of this. It is also not known whether factors such as stress or nutrition promote a PUPP syndrome. There is a small amount of evidence that women who suffered from a skin disease before pregnancy are slightly more likely to have PUPP than women who never had skin problems. A PUPP syndrome that occurs during pregnancy does not mean that a subsequent pregnancy must also have this skin problem.
Diagnosis of a PUPP syndrome
A PUPP syndrome is a diagnosis of exclusion that can be made without further diagnosis. A skin swab is usually only necessary if there is doubt about the diagnosis. The decisive factor is the sudden appearance in the second half of pregnancy and the typical appearance on the skin, which consists of reddish, sometimes converging raised structures.
As a rule, the pregnant woman also reports severe itching. Sometimes they describe similar symptoms in previous pregnancies. However, it would also be important to exclude other skin diseases as a cause during pregnancy, which would have to be treated accordingly.
To call would be the shingles, as well as a mushroom infestation of the skin, purely allergic skin reactions to environmental factors or care products. Also it should be paid attention with the patient questioning to the fact whether there were other accompanying symptoms, like e.g. fever, indisposition, weight acceptance etc. with the occurrence of the first skin symptoms.
A PUPP syndrome typically develops at the beginning on the abdomen. As the disease progresses, the plaques can also spread to the arms and legs (typically near the trunk). Shortly after the plaque-like formations develop, the tormenting itching begins, which then decreases in intensity again after a few days. With the formation of new plaques, which typically follow again and again, the itching also comes back. The affected persons thus suffer from a change in skin symptoms and itching.
