Pruritus + rashes

Question 1

Management of pregnant patient in contact with varicella/zoster-like rash?

Answer 1

If reliable PMH- reassure.

If not, check varicella IgG and offer VZ- immunoglobulin less than 10 days after contact

Question 2

When does pruritis gravidarum usually begin/peak?

Answer 2

Usually begins in the 3rd trimester; peaks in the last month

Question 3

Management of pruritus gravidarum?

Answer 3

Moisturisers- no role for antihistamines

Question 4

Intensely itchy rash on buttocks/lower abdomen occurring around week 35

Answer 4

Pruritic urticarial papules and plaques of pregnancy (PUPPP)

Question 5

When is the riskiest time for rubella infection in pregnancy?

Answer 5

<11 weeks- 90% have an adverse outcome

Question 6

How should contact with a non-vesicular, non-specific rash be managed?

Answer 6

Send blood for serology for parvovirus and rubella

Question 7

Febrile illness + arthritis + fine rash over trunk and extremities

Answer 7

Parvovirus

Question 8

Risks from rubella exposure? (4)

Answer 8

Deafness, cereberal palsy, learning disability, cataract

Question 9

Risks from parvovirus? (2)

Answer 9

Hydrops fetalis

Miscarriage

Question 10

Disseminated maculopapular rash which becomes confluent + corza + lymphadenopathy

Answer 10

Measles

Question 11

Risks from measles infection? (2)

Answer 11

Intrauterine death

Pre-term delivery

Question 12

When are people with chickenpox infectious from?

Answer 12

2 days prior to rash formation until rash has crusted over

Question 13

Risks to the baby from chickenpox in non-immune mother?

Answer 13

Miscarriage

Fetal varicella syndrome

Question 14

How long should pregnancy be avoided for, after chickenpox vaccination?

Answer 14

3 months

Question 15

Itchy rash developing into blisters, often starting around the umbilicus? Management?

Answer 15

Pemphigoid gestationis.

Topical steroids + oral antihistamines