Today is Day 5 of the horrible rash eruption. I am really dreading this. I have seen this condition in many of my patients during my Skin posting and to my horror – now I am a patient myself. I do not know what triggered it. I always have atopic eczema all my life so having itchy patches on my skin are nothing new. But never on my tummy.
On Friday night – I started to feel this unbearable itch from my tummy – I thought it was only dry skin as the belly stretches to accommodate my baby’s growth. But then tiny papules and macular rashes start to spread all over my tummy and the sides of my thighs on my few stretch marks. Then it hit me – I have been hit by Polymorphic Eruption of Pregnancy or Pruritic Urticarial Papules & Plaques of Pregnancy (PUPPP)
PUPPP usually begins in the third trimester which made me consider other diagnosis at first as I am barely at the end of my 2nd trimester. It is more common among women carrying twins and those having their first baby like yours truly. Also commoner in lady carrying boys (hubby is happy to know this… 
The eruptions usually show up first on the abdomen around or in stretch marks (just like what happened to me and may spread to your thighs, buttocks, and arms. PUPPP is harmless for you and your baby, but it really itch like crazy!
I SMSed my dermato lecturer for opinion – I have started on the usual combo of emulsifying ointment + aques cream + 1% Hydrocortisone which provide short relief. Restraining from my Palmer’s cocoa butter as I heard some may develop allergic reaction to it and make PUPP worse. Piriton does relieve the itch somewhat but it gives me a numbing headache. Cetrizine don’t help much with the itch. Trying Clarinase now so hopefully that would work.
The problem with being a doctor – you also know that this condition can only be managed with symptomatic relievers like antihistamines and emollients but the only definite cure for PUPPP is delivery of the baby. *but I am not going to deliver my baby anytime soon so I am going to suffer this for at least next 3-4 months. *sigh* with my exam coming up next month – it came at a very bad time.
For now – I only can hope and pray – continue preparing for baby’s arrival and clinical exam while trying to put up with this setback.
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