Dermatology - Polymorphic Eruption of Pregnancy
Polymorphic eruption of pregnancy is a frequently occurring condition that often starts in the third trimester, primarily affecting first-time pregnant women (76%). There is no heightened risk of harm or death to the fetus. Intense itching occurs on the belly, typically 1-2 weeks prior to childbirth. Nevertheless, symptoms and indications may emerge throughout the postpartum period. Abnormalities The skin lesions are characterized by red raised bumps, measuring 1-3 mm, that rapidly merge together to form hives with a circular shape and pattern. There are pale areas surrounding the edges of the lesions. Target lesions and small vesicles (2 mm) appear without blisters. Infrequently, the face, breasts, palms, and soles have minimal involvement. The area around the navel is typically unaffected. There is an absence of mucous membrane lesions. The diagnosis is made based on clinical examination, and the differential diagnosis covers all abdominal rashes that cause itching during pregnancy, such as medication reaction, allergic contact dermatitis, and metabolic pruritus. Highly potent topical steroids, which can frequently be gradually reduced, along with oral prednisone at doses ranging from 10 to 40 mg per day, effectively alleviate symptoms within 24 hours. Oral antihistamines lack efficacy. Most women do not experience a recurrence during the postpartum period, subsequent pregnancies, or when using oral contraceptives. In the event of a recurrence, it often manifests with significantly reduced severity.
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