Pruritic Urticarial Papules and Plaques of Pregnancy

Pruritic Urticarial Papules and Plaques of Pregnancy, aka PUPPP, is a benign condition that arises classically in the third trimester for a primiparous female.  Of note, a common dermatosis of pregnant females is atopic dermatitis of pregnancy, which occurs earlier in the pregnancy.

The classic description of PUPPP is the development of intensely pruritic urticarial papules within the striae of a primip.  HOwever, in some cases, it can occur in multips, and the lesions may not be confined to the striae.  Typically, there are no bullae, but there may be very small vesicles.

Of course, the IF is negative in PUPPP.  It would be positive in pemphigoides gestationis, but is never positive in PUPPP.