dermatological conditions In Pregnancy

Question 1

Pruritus gravidarum

Answer 1

● Usually occurs in early pregnancy
● Not associated with rash or jaundice
● Treat with topical antipruritics ± antihistamines
● Settles rapidly post-partum
● Can recur with subsequent pregnancies or oral contraceptive use.

Question 2

Commonest pregnancy-specific rash

Answer 2

Pruritic urticarial papules and plaques of pregnancy (PUPP)

Question 3

Pruritic urticarial papules and plaques of pregnancy (PUPP) Incidence

Answer 3

Incidence of 1/200–250 pregnancies
● Usually occurs after 35 weeks’ gestation
● Up to 15% initially occur immediately post-partum
● Three-quarters of cases occur in primiparous women

Question 4

Pruritic urticarial papules and plaques of pregnancy (PUPP) Manifestation

Answer 4

● Papules and plaques along striae on abdomen, with sparing of umbilicus
● Small vesicles can occur but not bullae
● Can spread to thighs, breasts, buttocks, and upper arms
● Pathogenesis unknown but may be related to skin distension, as more common in multiple gestations and
pregnancies with excessive weight gain
● Resolves rapidly after delivery

Question 5

Pruritic urticarial papules and plaques of pregnancy (PUPP) Association and management

Answer 5

● No fetal risks
● Can be associated with maternal hypertension
● Treat with 1% aqueous menthol cream, topical steroids ± antihistamines
● Recurrence is rare and usually mild.

Question 6

The most common skin cancer in pregnancy

Answer 6

Melanoma

Question 7

Most common cause of bleeding per nipple

Answer 7

Duct papilloma

Question 8

Most common cause of physiological nipple discharge

Answer 8

Duct ectasia