Pruritic Urticarial Papules and Plaques of Pregnancy: Clinical Experience with 22 Patients

Seo, Jong Keun; Chun, Ji Sung; Hwang, Seon Wook; Sung, Ho Suk; Lee, Deborah

Abstract

BACKGROUND
Pruritic urticarial papules and plaques of pregnancy is a common benign dermatosis of pregnancy. It occurs mainly in primigravidas in the third trimester, it resolves spontaneously or with delivery, and it is usually responsive to topical treatment. The morphological spectrum of pruritic urticarial papules and plaques of pregnancy includes (1) urticarial papules and plaque (type I), (2) non-urticarial erythematous patches that are discrete or confluent and they are surrounded by tiny papules or vesicles, or clusters or sheets of 1-mm to 2-mm erythematous papules (type II) and (3) a combination of these features (type III).
OBJECTIVE
This study evaluated our clinical experience with 22 Korean patients with pruritic urticarial papules and plaques of pregnancy.
METHODS
From June 1997 to August 2008, 22 patients with pruritic urticarial papules and plaques of pregnancy were evaluated. The clinical manifestations, the lesion distribution and the obstetric and pediatric findings were retrospectively investigated with using the patients' medical records and clinical photographs.
RESULTS
There were 9, 11 and 2 patients with types I to III, respectively. Many patients (n=14) were primigravida and the mean time of onset was a gestational age of 29.8 weeks. There were no pediatric problems such as intra-uterine growth retardation, or a small or large size for the gestational age.Most of the patients (n=20) were treated with topical corticosteroid or antihistamine; there was one case of recurrent pruritic urticarial papules and plaques of pregnancy.
CONCLUSION
Pruritic urticarial papules and plaques of pregnancy usually occur in primigravidas, but this can also occur in multigravida patients. The number of patients with pruritic urticarial papules and plaques of pregnancy and who had obstetric obesity, a multiple pregnancy or pregnancy-induced hypertension was fewer than we expected. Pruritic urticarial papules and plaques of pregnancy can be divided into three categories, although this is rather redundant because the disease prognosis and treatments are not different according to the type.