The numerous red bumps of PUPPP sometimes look like hives and are intensely itchy. Multiple small scabs are seen on the buttocks from scratching the lesions of PUPPP. Some of the lesions are seen in stretch marks here. The eruption from PUPPP can be extensive, here involving not only the stomach but also the arms with hive-like, red swellings. PUPPP usually begins in the third trimester and is more common among women carrying twins.
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PUPPP (Pruritic Urticarial Papules Plaques of Pregnancy)  Information for adults

Picture of PUPPP (Pruritic Urticarial Papules Plaques of Pregnancy): The numerous red bumps of PUPPP sometimes look like hives and are intensely itchy. Divider line
The numerous red bumps of PUPPP sometimes look like hives and are intensely itchy.
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Self-Care Guidelines
Thick moisturizers can be applied to the rash throughout the day to prevent dryness and relieve itching. An over-the-counter topical steroid such as hydrocortisone (0.5 or 1%) may be applied to affect areas. An over-the-counter antihistamine such as diphenhydramine (Benadryl®) is safe to take during pregnancy and can decrease the itching, but it may make you sleepy. Loratadine (Claritin®) and cetirizine (Zyrtec®) are other antihistamines that are less sedating and may help during the day.
When to Seek Medical Care
The most common treatment your doctor will give you is a steroid cream – either prescription-strength or something available over the counter – to be applied directly to the affected areas. Only in severe cases are oral steroids required to control the itching. Rarely, if your doctor is unsure of the diagnosis of PUPPP, he or she may recommend a skin biopsy to confirm the diagnosis.
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Last Modified: 13 Feb 2009
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