Introduction
Prurigo of pregnancy (PP) is the most contentious pregnancy dermatosis classification. Historically, the characteristics of this disorder have been ill-defined. Its current classification includes pruritic folliculitis and papular dermatitis, which some regard as distinct disease processes. It is hypothesized that prurigo of pregnancy is caused by pruritus gravidarum in atopic women and that most of these patients simply have atopic dermatitis. Nonetheless, unless a clear alternative etiology can be identified, patients with typical clinical features are typically diagnosed with pregnancy prurigo.
Pregnancy prurigo affects one in every 300 pregnancies. It can occur at any time during pregnancy, but it is most common in the second and third trimesters (between 13 and 40 weeks). Pregnancy prurigo typically subsides soon after the baby is born. However, some women experience a rash or itchy skin for several weeks after giving birth. Pregnancy prurigo may appear in future pregnancies if they intend to have more children. Work with the doctor to manage the symptoms and stay comfortable until the rash disappears.
What Is Prurigo of Pregnancy?
Prurigo of pregnancy (also known as papular dermatitis of pregnancy) is a skin rash that causes itchy, discolored bumps. It usually does not cause problems for the mother or the developing fetus. It can appear anytime during pregnancy but is often seen in the second or third trimester. It may last for several months after childbirth. The healthcare provider can diagnose pregnancy prurigo and recommend treatment based on the symptoms.
What Causes Prurigo of Pregnancy?
The cause of pregnancy prurigo is currently unknown. The association, or lack thereof, with atopic dermatitis is debatable. It does not cause complications, and people with the condition can still have healthy pregnancies. According to some studies, prurigo is linked to:
-
Pregnancy cholestasis (a liver disorder).
-
Immune system modifications.
-
Increase in blood volume.
What Are the Clinical Features of Prurigo of Pregnancy?
The prurigo of pregnancy rash appears on the skin as small bug bites, acne, or pimples. These bumps could be crusty or scaly in texture. Prurigo rash spots are pink, red, or purple in color. Some may contain hair follicles and cause severe itching and discomfort. The spots caused by pregnancy prurigo can be as tiny as the tip of a pencil or as large as the eraser at the top of a pencil. They usually cluster together in groups. It usually manifests as papular dermatitis (prurigo). It is similar to nodular prurigo.
-
They are mostly seen on the extensor region of the limbs and occasionally on the trunk.
-
Papules range in size from 0.5 to 1 cm.
-
Blisters (vesicles) are not visible, but pustules are.
-
Due to itching, the papules are frequently excoriated.
What Are the Risk Factors for Prurigo of Pregnancy?
Currently, no risk factors for prurigo of pregnancy have been identified. Understanding that having a risk factor does not guarantee that one will develop the condition. A risk factor increases one's chances of developing a condition when compared to someone who does not have the risk factors. Certain risk factors are more significant than others. Furthermore, the absence of a risk factor does not rule out the possibility of developing the condition. Therefore, it is always best to talk to the doctor about the impact of risk factors.
How Is Prurigo of Pregnancy Diagnosed?
During a physical examination, healthcare providers can diagnose pregnancy prurigo. The symptoms must be tracked when they first appear. The healthcare provider may advise urine or blood tests to rule out other conditions, such as pregnancy cholestasis or autoimmune conditions. The histopathology of pregnancy prurigo reveals non-specific dermatitis. Direct immunofluorescence yields a negative result.
-
Dermoscopy: It is a diagnostic tool in which a dermatologist examines the skin with a magnifying lens.
-
Wood’s Lamp Examination: The healthcare provider examines the skin with ultraviolet light during this procedure. It is used to examine changes in skin pigmentation.
-
Biopsy of the Skin: A skin biopsy is taken and sent to a laboratory for pathological analysis. Under a microscope, the pathologist examines the biopsy. The pathologist arrives at a definitive diagnosis after combining clinical findings, special studies on tissues (if necessary), and microscope findings.
Are Pregnancy Prurigo and PUPPP Rash the Same?
The most common type of pregnancy rash is pruritic urticarial papules and plaques of pregnancy (PUPPP). It occurs in one out of every 160 pregnancies. In case of expecting twins, triplets, or more, one may be at a higher risk. Itchy, discolored bumps or patches on the skin are also symptoms of PUPPP rash. It commonly appears on areas of the skin that are extremely stretched during pregnancy, such as the abdomen, buttocks, or thighs. The last months of pregnancy are the most common time for PUPPP rash to appear. Pregnancy prurigo can occur anywhere on the body. Both conditions are not harmful to the fetus.
What Is the Treatment for Prurigo of Pregnancy?
Pregnancy prurigo treatment may include the following:
-
Antihistamines taken orally.
-
Hydrocortisone cream or ointment (steroid).
-
Benzoyl peroxide (topical).
-
Menthol-containing lotions.
-
Calamine lotion.
-
Phototherapy.
Before taking any over-the-counter (OTC) medication or applying anything to the skin, a physician must be consulted. The following measures can help pregnancy prurigo symptoms:
-
Make sure to apply unscented lotion or moisturizers several times per day.
-
Wear comfortable clothing that does not irritate the skin.
-
Wear clothing made of natural fibers such as cotton or silk.
-
Following the healthcare provider's recommendations for symptom relief.
When Should I Make an Appointment With My Doctor?
If any changes in the skin are noticed while pregnant, a healthcare provider must be consulted. This includes new rashes, itchy or painful rashes, and infection symptoms (like pus-filled bumps). As the body changes during pregnancy, some rashes and skin conditions are unique. Most skin conditions are usually harmless, but it is better to confirm with a doctor.
What Is the Prognosis of Prurigo of Pregnancy?
Even in severe cases, the maternal prognosis is good because skin lesions usually respond quickly to therapy; however, recurrence in subsequent pregnancies is common. The fetal prognosis is unaffected; however, there is a risk of the infant developing atopic skin changes.
Conclusion
Prurigo is a harmless non-specific pruritic papular rash that causes itchy bumps on your skin, arises during pregnancy, and disappears shortly after the baby is born. However, skin rashes or bumps should always be examined because they could indicate a more serious condition. In most cases, the doctor may prescribe topical creams or anti-itch medications to alleviate the symptoms.
