Pruritic Urticarial Papules and Plaques of Pregnancy Occurring Postpartum Treated with Intramuscular Injection of Autologous Whole Blood

Abstract

Pruritic urticarial papules and plaques of pregnancy (PUPPP) is one of the most common diseases associated with pregnancy. In most cases, the skin lesions develop in the third trimester of primigravidas. There are no systemic alterations seen in PUPPP; however, most patients report severe pruritus. A 34-year-old woman presented 1 week postpartum with typical clinical features of PUPPP. The patient showed good response to intramuscular injection of autologous whole blood with no adverse effects to the patient or her baby. Presentation of PUPPP in the postpartum period is rare. Conservative management with topical corticosteroids and oral antihistamines is commonly used to relieve pruritus. In severe cases, skin lesions and symptoms are controlled with a brief course of systemic corticosteroids. Investigation of new treatment options has been limited by patient concerns about the negative effects of medication on the fetus or breastfeeding. Intramuscular injection of autologous whole blood could be an alternative treatment option for PUPPP, especially for women who worry about the use of medications during pregnancy or breastfeeding.

Postpartum polymorphic eruption of pregnancy: an unusual presentation

“…Polymorphic eruption of pregnancy (PEP), or pruritic urticarial papules and plaques of pregnancy (PUPPP), is a benign, self‐limited dermatosis that usually presents in the third trimester of pregnancy. A postpartum presentation of the condition is uncommon, with only a few cases described in the literature . The disorder is associated with primigravidas and multiple gestation pregnancies, yet recurrence in subsequent pregnancies is rare .…”

Polymorphic eruption of pregnancy as a possible COVID ‐19 manifestation

“…In addition, the detection of abdominal striae distensae is relevant for differential diagnosis; however, these lesions were not observed in this case. 8 Moreover, our patient referred that fever, headache and diarrhea had started simultaneously with the cutaneous rash, suggesting the assumption of the role of SARS-CoV-2 in its pathogenesis. Furthermore, prompt regression of the rash with high doses of corticosteroids, even if the patient is still infective, leads us to suspect an hypersensitivity reaction against viral antigens as a possible pathogenetic mechanism.…”

Erupción polimorfa durante el puerperio inmediato

“…En 2017, Kim describió el caso de una mujer de 34 años quien, luego de una semana del parto, presentó una erupción cutánea generalizada acompañada de prurito. Como dato adicional se observó una ganancia de peso durante la gestación de 13 kg, situación similar a la reportada en el presente manuscrito (11). En cuanto al tratamiento del síndrome, han surgido nuevas alternativas como las reportadas por Jeon et al, donde tres pacientes rechazaron la medicación convencional por miedo a los efectos adversos, siendo manejadas con inyecciones intramusculares de sangre entera autóloga logrando la resolución de los síntomas (12).…”