Preganancy-related rashes Flashcards
(42 cards)
What is Polymorphic Eruption of Pregnancy (PEP)?
Common intensely pruritic skin lesions occurring in the last trimester of pregnancy or immediate postpartum period
Also known as Pruritic Urticarial Papules and Plaques of Pregnancy (PUPPP)
In which trimester does Polymorphic Eruption of Pregnancy primarily occur?
Last trimester of pregnancy or immediate postpartum period
Which pregnancies are more likely to experience Polymorphic Eruption of Pregnancy?
Primarily first pregnancies and multigestational pregnancies
Does Polymorphic Eruption of Pregnancy run in families?
No, it doesn’t run in families
What factors increase the likelihood of developing Polymorphic Eruption of Pregnancy?
- First pregnancy
- Multigestational pregnancy
- Excessive weight gain
Where do the skin lesions of Polymorphic Eruption of Pregnancy typically start?
In striae/stretch marks on the abdomen
Which areas are typically spared from Polymorphic Eruption of Pregnancy lesions?
- Head
- Palms and soles
- Genital area
- Umbilicus
What are the clinical features of Polymorphic Eruption of Pregnancy?
- Edematous urticarial papules that become plaques
- Non-urticatial erythematous rash
- Small vesicles that leak straw-coloured fluid
What colors do the lesions appear on light and dark skin tones?
- Pink on light skin tones
- Dark red-brown on dark skin tones
What is the typical duration for Polymorphic Eruption of Pregnancy to resolve?
4-6 weeks
What is the management approach for Polymorphic Eruption of Pregnancy?
- Usually self-limiting
- Emollients and bath soap substitutes
- Pregnancy-safe oral antihistamines
True or False: Polymorphic Eruption of Pregnancy poses a risk to the fetus or mother.
False
What types of oral antihistamines are recommended for Polymorphic Eruption of Pregnancy?
- Loratadine
- Cetirizine
What type of rash can develop from the non-urticatial erythematous rash in Polymorphic Eruption of Pregnancy?
Eczema plaques or targetoid lesions
Fill in the blank: Polymorphic Eruption of Pregnancy is also known as _______.
Pruritic Urticarial Papules and Plaques of Pregnancy (PUPPP)
What type of diagnosis is used for Polymorphic Eruption of Pregnancy?
Clinical diagnosis
What is Pemphigoid gestationis (PG)?
A rare form of bullous pemphigoid that presents during the third trimester or immediate postpartum period.
What is the pathophysiology of Pemphigoid gestationis?
Circulating IgG autoantibodies target the antigens collagen XVII (BP antigen 2, BPAG2) and BPAG1, which are found on hemidesmosomes.
What can induce Pemphigoid gestationis?
It can be drug-induced, for example, by sulfur-containing drugs like furosemide, sulfasalazine, and antibiotics like amoxicillin and penicillin.
What are the clinical features of Pemphigoid gestationis?
Lesions begin around and inside the umbilicus, then diffuse to the abdomen and extremities, with intense pruritus followed by erythematous urticarial plaques and papules.
What are the characteristics of the lesions in Pemphigoid gestationis?
Tense vesicles and bullae with clear fluid, similar to those in bullous pemphigoid.
What is the gold standard investigation for Pemphigoid gestationis?
Direct Immunofluorescence (DIF) microscopy, which shows linear IgG and/or linear C3 deposits along the dermoepidermal junction.
What other investigations can be done for Pemphigoid gestationis?
An ELISA assay will identify anti-BPAG2 and anti-BPAG1 antibodies, and tissue biopsy histology shows subepidermal bullae with eosinophilic infiltrate.
How does Pemphigoid gestationis differ from PEP?
PG has periumbilical involvement and causes bullae, while PEP has no periumbilical involvement and doesn’t cause bullae.
