Department of Obstetrics, American University of Beirut-Medical Center, Beirut, Lebanon.
Int J Dermatol. 2012 Sep;51(9):1047-53. doi: 10.1111/j.1365-4632.2011.05203.x.
Pruritic urticarial papules and plaques of pregnancy (PUPPP) is a benign pruritic inflammatory skin disorder that usually affects primigravidae in their third trimester of pregnancy. Studies on this condition from our area are lacking.
To describe the epidemiological, clinical, and histopathological findings of all patients diagnosed with PUPPP at the American University of Beirut Medical Center (AUB-MC) between 1998 and 2009 and compare our findings with those published in the literature.
PUPPP mainly affected primigravidae (72%) in the third trimester of pregnancy (89%). Multiple gestation pregnancies were observed in 50% of cases. The abdomen and proximal thighs were the most commonly involved sites (67%), with exclusive involvement of the extremities in four cases. Although pruritic urticarial papules and plaques were the main morphological feature of PUPPP observed (98%), five cases had additional features, and one case presented exclusively with papulovesicular lesions. Microscopically, all cases biopsied showed the typical features of PUPPP, including negative direct immunofluorescence findings. Emollients, topical corticosteroids, and/or oral antihistamines were generally adequate to control symptoms in all cases, in which skin lesions resolved in an average of three weeks.
This study showed a lower incidence of PUPPP in our population compared with its incidence in other populations. It also confirmed the previously described clinical features, benign course, and excellent outcome of the condition, although variations may occur. Significant associations mainly included multiple gestation pregnancies, excessive maternal weight, and Rh-positive blood type, while fetal gender and weight gain did not contribute.
妊娠瘙痒性荨麻疹性丘疹斑块病（PUPPP）是一种良性瘙痒性炎症性皮肤病，通常发生在妊娠晚期的初产妇中。目前我们地区对此疾病的研究较少。
描述 1998 年至 2009 年期间在贝鲁特美国大学医学中心（AUB-MC）诊断为 PUPPP 的所有患者的流行病学、临床和组织病理学发现，并将我们的发现与文献中的发现进行比较。
PUPPP 主要影响妊娠晚期的初产妇（72%）（89%）。50%的病例中存在多胎妊娠。腹部和近端大腿是最常见的受累部位（67%），有 4 例仅累及四肢。虽然瘙痒性荨麻疹性丘疹和斑块是观察到的 PUPPP 的主要形态特征（98%），但有 5 例存在其他特征，1 例仅表现为丘疹水疱性病变。所有活检病例均显示出典型的 PUPPP 特征，包括阴性直接免疫荧光结果。在所有病例中，润肤剂、局部皮质类固醇和/或口服抗组胺药通常足以控制症状，皮损平均在三周内消退。
与其他人群相比，本研究显示我们人群中的 PUPPP 发病率较低。它还证实了该疾病先前描述的临床特征、良性病程和良好的结果，尽管可能存在变异。主要的显著关联包括多胎妊娠、产妇体重过大和 Rh 阳性血型，而胎儿性别和体重增加则没有影响。
