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symptoms are extremely unbearable, early delivery can be discussed with the patient if the other treatments are ineffective. However, early delivery of the baby still does not guarantee that the symptoms will be gone. Luckily, in most cases, steroid treatment works efficiently and symptoms are generally greatly improved within several days. As with most steroid treatments, the usage of it is a controversial topic. Nonetheless, short-term or one-time use is advisable, and tends to be safer while using it during the third trimester compared to the first trimester.
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baby. As mentioned above, the papules and plaques usually first appear on the abdomen (although not on the umbilicus/belly button) and often spread to the legs, chest, underarms, etc. However, lesions on or above the breasts are rare. That's why the face is usually spared and does not become affected. As a result of these papules and plaques from PUPPP, it causes the skin to be very itchy (pruritic) and immensely affects the patient's sleep quality throughout the night.
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usually occur during the earlier periods of gestation and often involve the umbilicus; as well as, having a positive immunofluorescence of perilesional skin. If there is eczema, people generally have a history of atopy, be it personal or through family. The eruption is identified by pruritic erythematous lesions on flexural areas. Furthermore, other clinical differential diagnosis could be from drug eruptions, urticaria, or viral exanthems.
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36:
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320:(IgM) deposition at the dermal-epidermal membrane has been associated with a variety of dermatosis including PUPPP. The problem with the hypothesis that has been proposed is that this condition does not reoccur and it does not progressively worsen. Currently there has been no evidence of detecting circulating antibodies that are associated with the onset on PUPPP in an individual.
217:
happens, people report noticing the skin surrounding the rash to appear white in color (blanched) and in the shape of "halos". Multiple features of the disease can continue with time and have been reported as widespread erythema (a red skin rash due to damage of underlying capillaries) and patches of inflamed, itchy, rough, and cracked patches of skin that appear similarly to
282:. With this increase in progesterone, it causes there to be an increased level of progesterone receptors present eliciting an immune reaction seen by skin lesions in PUPPP. With multiple gestations, there is an increase in sex hormones that has been seen those with the condition such as an increase in progesterone as previously discussed but also higher levels of
265:. This reaction has been seen more frequently in those who are having twins or triplets compared to those with single births. This is hypothesized to be due to increased stretching of the abdominal wall while carrying twins or triplets, causing an earlier onset of PUPPP when compared to those undergoing single births.
430:
fetus or fetuses. The use of high-potency topical corticosteroids over 300 grams throughout the pregnancy may increase the risk of low birth weight for the baby. Rarely, in unusually persistent and distressing cases, some women have had their labor induced as soon as they are considered to be at term (37 weeks).
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creams and ointments are used in more aggressive cases, and oral (systemic) corticosteroids can be used to treat very severe cases—although the benefits of a pregnant woman's ingesting high-potency corticosteroids must be weighed carefully against possible (and mostly unknown) risks to the developing
378:
A common misdiagnosis is urticarial pemphigoid gestationis, hence it is needed to exclude it while diagnosing PUPPP as clinical features can overlap. Therefore, histological and immunological studies are necessary to ensure there is no mis-diagnosis. During the case of pemphigoid gestationis, lesions
391:
It is important to note that diagnosis should be conducted by a trusted medical professional. In the case that a woman is experiencing symptoms of PUPPP, it is recommended that they contact their primary care physician for referral to a dermatologist for treatment guidance and should not self-treat.
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This skin condition occurs mostly in first pregnancies (primigravida), in the third trimester and is more likely with multiple pregnancies (more so with triplets than twins or singletons). Estimated 75% of people with typical PUPPP people have never given birth. Occasionally, this condition may also
216:
This rash usually begins with the skin looking abnormally red and feeling itchy, accompanied by notable swelling of skin tissue that appears raised and within the stretch marks. Over time, individual segments of this rash can join to form one whole, larger rash with the same characteristics. As this
433:
When the pruritus is unbearable to the patient with PUPPP, oral prednisone in doses of 10 to 40 mg/day has been generally used for these type of severe cases. With this treatment, symptoms are usually relieved after 24 hours of the oral treatment. Sometimes, if the cases are too severe and the
299:
From those with PUPPP, it has been seen from an immunohistology profile which is used to determine the of tissue components present within an individual via the use of antibodies, that there are certain immune cells that are in greater amount compared to that of those without PUPPP. Immunohistology
228:
The timeline of onset for these symptoms has been reported with some variability. However, most people report experiencing symptoms during the third trimester (last few weeks of pregnancy) where 15% of the women who have PUPPP reported that symptoms actually began immediately after delivery of the
382:
Sometimes, people may require a 3- or 4-mm punch biopsy to exclude herpes gestationis, which is a variant of bullous pemphigoid occurring during or immediately after pregnancy. Usually the biopsy has features that are consistent with PUPPP but there are no pathognomonic symptoms of the particular
212:
PUPPP most commonly presents as a rash that starts within the stretch marks. This rash may then move to other areas of the body, including, but not limited to the trunk of the body, arms, legs, feet, chest, and neck. Very few people experiencing PUPPP have reported the rash spreading to the face,
199:
PUPPP usually first appears on the abdomen and often spreads to the legs, feet, arms, chest, and neck. The face is usually not affected. Skin distension (stretching) is thought to be a possible trigger for PUPPP as it most commonly affects primigravida (women in their first pregnancy), those with
399:
One of the most recent forms of treatment suggested is the intramuscular injection of autologous whole blood as an alternative treatment option for people affected by PUPPP right after childbirth, as it seems to have both subjective and objective improvements of the symptoms. This is a very good
242:. Although the exact cause of the condition is not known and varying amongst individuals, there have been theories linking the cause of PUPPP to hormonal alterations, damage to the connective tissue during pregnancy, and autoimmune disorder where the evidence for these theories is currently low.
307:
It has been hypothesized that PUPPP appears in response to fetal antigens that circulate throughout the body. For example, a study showed that fetal male DNA was found within the lesions of the mother's skin which was thought to be caused by the fetal cells seen in the mother's blood throughout
224:
Certain reports have shown there is a positive correlation between PUPPP and excessive maternal weight gain along with increased newborn birth weight. Additionally, a study from
Ghazeeri and al. showed that 89% of people who underwent conception through in vitro fertilization were Rh-positive.
189:, that people have prior to getting pregnant will become altered or symptoms will increase. Pruritic urticarial papules and plaques of pregnancy (PUPPP) is one of many skin conditions that is specific to pregnancy and occurs in about 1 in every 160 (0.625%) of pregnancies.
200:
large fundal measurements (distance from the pubic bone to the top of the uterus) and/or those who are carrying large babies or multiples. The papules and plaques often first appear within stretch marks before changing appearance and spreading to other areas of the body.
273:
Throughout pregnancy, there are hormonal changes that occur where it has been hypothesized that these changes may contribute to the onset of PUPPP. Although current research is low on this hypothesis, it has been seen that those who have had multiple
406:
tablets may be prescribed to provide relief from the itch, although they are generally considered much less effective than corticosteroid treatments, and may decrease itching through blocking histamine release as well as improving sleep quality.
237:
PUPPP is the most common dermatosis of pregnancy and is the most frequent in pregnant women habitating a male fetus, women who had quick and conspicuous weight gain during a short period, and women who ultimately deliver by a
203:
For those who may be experiencing signs and symptoms of PUPPP, it is strongly recommended they speak with their primary care physician and receive a consult from a dermatologist regarding skin changes during pregnancy.
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In the majority of cases, PUPPP resolves within a few days or weeks upon initial onset or spontaneously within a week of delivery. However, a few women continue to experience symptoms long into the postpartum period.
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PUPPP is often a diagnosis of exclusion and may need laboratory testing to rule out other dermatoses. Lab tests may include complete blood count, comprehensive metabolic panel, liver function tests, serum
53:
2150:
1568:"Dermatological Diseases Associated with Pregnancy: Pemphigoid Gestationis, Polymorphic Eruption of Pregnancy, Intrahepatic Cholestasis of Pregnancy, and Atopic Eruption of Pregnancy"
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disorder. Additionally, a biopsy of unaffected perilesional skin could be used for direct immunofluorescence studies to have a more precise exclusion of herpes gestationis.
371:
and serum cortisol. Additional specialized tests may include serum for indirect immunofluorescence or biopsy of the lesions for direct immunofluorescence to rule out
192:
It presents no long-term risk for either the woman or fetus as there is no statistical increase of risk of premature labor or fetal loss, despite frequently severe
221:. Other features have been reported in some cases of those experiencing PUPPP, such as tiny vesicles, however these are not as common and develop after more time.
100:
72:
1355:
Ohel I, Levy A, Silberstein T, Holcberg G, Sheiner E (May 2006). "Pregnancy outcome of patients with pruritic urticarial papules and plaques of pregnancy".
79:
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During pregnancy as the abdominal wall rapid stretching, it is hypothesized that there is an inflammatory reaction that occurs due to the exposure of
86:
2750:
17:
2881:
68:
509:
Elling, SV; McKenna, P; Powell, FC (September 2000). "Pruritic urticarial papules and plaques of pregnancy in twin and triplet pregnancies".
1805:"Pruritic Urticarial Papules and Plaques of Pregnancy Occurring Postpartum Treated with Intramuscular Injection of Autologous Whole Blood"
868:"Pruritic urticarial papules and plaques of pregnancy: epidemiological, clinical, and histopathological study of 18 cases from Lebanon"
474:
Matz H, Orion E, Wolf R (2006). "Pruritic urticarial papules and plaques of pregnancy: polymorphic eruption of pregnancy (PUPPP)".
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profile have shown cells consistent with a delayed hypersensitivity with T helper cell infiltrates, dendritic cells and epidermal
93:
2388:
2355:
1400:"Female-specific pruritus from childhood to postmenopause: clinical features, hormonal factors, and treatment considerations"
631:
446:
286:. Currently evidence is weak in the role that sex hormones play when contributing to PUPPP where further research is needed.
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Pine tar soap/body wash can also bring relief as can keeping the skin chilled such as through a cold shower or iced cloths.
2004:
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such as loratadine and cetirizine are non-sedating and may also be effective in controlling pruritus in pregnant people.
2403:
1748:
Brandão, Pedro; Sousa-Faria, Bárbara; Marinho, Carla; Vieira-Enes, Pedro; Melo, Anabela; Mota, Lurdes (February 2017).
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Although this condition has not been determined as an autoimmune condition, from a single study it has been seen that
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119:
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1310:"Pruritic urticarial papules and plaques of pregnancy: clinical and immunopathologic observations in 57 patients"
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and induction of labour, there are no observed difference in the outcome of the pregnancy for mothers or babies.
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57:
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Aractingi, S.; Berkane, N.; Bertheau, P.; Le Goué, C.; Dausset, J.; Uzan, S.; Carosella, E. D. (1998-12-12).
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1956:"Pregnancy outcomes after maternal exposure to topical corticosteroids: a UK population-based cohort study"
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781:"Pruritic urticarial papules and plaques of pregnancy. Clinical experience in twenty-five patients"
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185:. Some skin changes are known to occur in people who are pregnant while other skin conditions, or
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Journal of
Obstetrics and Gynaecology: The Journal of the Institute of Obstetrics and Gynaecology
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option for the people who are worried about taking medications during pregnancy or breastfeeding
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are used to treat PUPPP, and ideally tapering it off after 7 days of therapy. Class I or II
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Aronson, I. K.; Bond, S.; Fiedler, V. C.; Vomvouras, S.; Gruber, D.; Ruiz, C. (1998).
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414:, have proven to be safe in pregnancy and can be a supplement treatment for pruritus.
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occur postpartum, but rarely does this ever occur in the first and second trimester.
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Chi, Ching-Chi; Wang, Shu-Hui; Mayon-White, Richard; Wojnarowska, Fenella (2013).
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Tunzi M, Gray GR (January 2007). "Common skin conditions during pregnancy".
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1989:
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1719:"Pruritic urticarial papules and plaques of pregnancy occurring postpartum"
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Brzoza, Zenon; Kasperska-Zajac, Alicja; OleĹ›, Ewa; Rogala, Barbara (2007).
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Knowing that oral antihistamines are generally ineffective, high-potency
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Sävervall, Christine; Sand, Freja Lærke; Thomsen, Simon
Francis (2015).
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2005:"Pruritic urticarial papules and plaques of pregnancy: an unusual case"
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Petropoulou, Haritini; Georgala, Sofia; Katsambas, Andreas D. (2006).
1458:"Pruritic urticarial papules and plaques of pregnancy: current status"
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1901:"Use of antihistamine drugs in early pregnancy and delivery outcome"
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660:"Pregnancy dermatoses: diagnosis, management, and controversies"
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Rimoin, Lauren P.; Kwatra, Shawn G.; Yosipovitch, Gil (2013).
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1255:"Recent developments in the specific dermatoses of pregnancy"
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Pruritic urticarial papules and plaques of pregnancy (PUPPP)
1510:
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1354:
1307:
193:
178:
1750:"Polymorphic eruption of pregnancy: Review of literature"
1627:"Fetal DNA in skin of polymorphic eruptions of pregnancy"
1397:
1185:"Pruritic urticarial papules and plaques of pregnancy"
975:
973:
971:
835:"Pruritic Urticarial Papules And Plaques Of Pregnancy"
410:
Furthermore, first-generation antihistamines, such as
69:"Pruritic urticarial papules and plaques of pregnancy"
2877:
Pathology of pregnancy, childbirth and the puerperium
1905:
The
Journal of Maternal-Fetal & Neonatal Medicine
1234:
Pruritic
Urticarial Papules and Plaques of Pregnancy
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Taylor, Drew; Pappo, Eden; Aronson, Iris K. (2016).
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Pruritic urticarial papules and plaques of pregnancy
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60:. Unsourced material may be challenged and removed.
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779:Yancey, K. B.; Hall, R. P.; Lawley, T. J. (2003).
2751:Childbirth-related post-traumatic stress disorder
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728:, Treasure Island (FL): StatPearls Publishing,
563:American Journal of Obstetrics & Gynecology
1686:Chapter 5 - Urticarial and Indurated Eruptions
1314:Journal of the American Academy of Dermatology
1095:Journal of the American Academy of Dermatology
785:Journal of the American Academy of Dermatology
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1851:
833:Chouk, Chourouk; Litaiem, Noureddine (2021),
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1996:
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832:
557:Kroumpouzos, George; Cohen, Lisa M. (2003).
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1048:Seminars in Cutaneous Medicine and Surgery
922:"Pruritus in Pregnancy and Its Management"
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1828:
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1189:Journal of Midwifery & Women's Health
883:
751:
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120:Learn how and when to remove this message
27:Chronic rash that occurs during pregnancy
1041:
865:
664:American Journal of Clinical Dermatology
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256:
249:Other than additional associations with
1462:The Australasian Journal of Dermatology
1145:CHAPTER 15 - Pregnancy: Third Trimester
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289:
14:
2882:Pregnancy-related cutaneous conditions
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1898:
612:Itch - Management in Clinical Practice
469:
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2389:Intrahepatic cholestasis of pregnancy
2356:Intrahepatic cholestasis of pregnancy
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1259:Clinical and Experimental Dermatology
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915:
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720:Kurien, George; Badri, Talel (2021),
447:Intrahepatic cholestasis of pregnancy
207:
2455:Pregnancy-induced hypercoagulability
2002:
1682:"Urticarial and Indurated Eruptions"
1517:International Journal of Dermatology
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872:International Journal of Dermatology
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58:adding citations to reliable sources
29:
1802:
1513:"Polymorphic eruption of pregnancy"
1029:"Polymorphic eruption of pregnancy"
982:"Polymorphic eruption of pregnancy"
614:. Current Problems in Dermatology.
464:
24:
2404:Pruritic folliculitis of pregnancy
1694:10.1016/B978-0-323-48553-1.00005-7
1446:
1223:
1153:10.1016/B978-0-443-07277-2.00017-9
1129:
1026:
998:10.1016/j.clindermatol.2016.02.011
908:
488:10.1016/j.clindermatol.2005.10.010
278:can exhibit an increased level of
268:
213:palms of hands, or soles of feet.
25:
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2662:Pain management during childbirth
2589:Twin-to-twin transfusion syndrome
2041:
1572:Dermatology Research and Practice
819:
706:
545:
167:polymorphic eruption of pregnancy
18:Polymorphic eruption of pregnancy
2848:
2847:
2834:Sexual activity during pregnancy
1852:Schatz, M.; Petitti, D. (2002).
1529:10.1111/j.1365-4632.2006.02715.x
1474:10.1111/j.1440-0960.2005.00160.x
1271:10.1111/j.1365-2230.2011.04173.x
885:10.1111/j.1365-4632.2011.05203.x
676:10.2165/11532010-000000000-00000
523:10.1046/j.1468-3083.2000.00026.x
416:Second-generation antihistamines
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181:that strikes some women during
45:needs additional citations for
2336:Acute fatty liver of pregnancy
1973:10.1001/jamadermatol.2013.5768
1854:"Antihistamines and pregnancy"
772:
658:Roth, Maria-Magdalena (2011).
608:"Itch in Pregnancy Management"
599:
502:
165:), known in United Kingdom as
13:
1:
2538:Prelabor rupture of membranes
1870:10.1016/S1081-1206(10)63382-0
1766:10.1080/01443615.2016.1225019
1643:10.1016/S0140-6736(98)05121-6
1326:10.1016/s0190-9622(98)70265-8
1107:10.1016/s0190-9622(99)70194-5
1060:10.1016/s1085-5629(98)80011-4
797:10.1016/s0190-9622(84)80097-3
457:
311:
2817:Systemic lupus erythematosus
2468:Maternal care related to the
2450:Gestational thrombocytopenia
1688:. Elsevier. pp. 63–82.
1680:Fitzpatrick (January 2018).
1141:"Pregnancy: Third Trimester"
511:J Eur Acad Dermatol Venereol
452:List of cutaneous conditions
386:
323:
7:
2618:Cephalopelvic disproportion
2003:De G, De G (January 2002).
1809:Case Reports in Dermatology
1357:J Matern Fetal Neonatal Med
440:
10:
2898:
2729:Breastfeeding difficulties
2528:Constriction ring syndrome
2502:Braxton Hicks contractions
1201:10.1016/j.jmwh.2006.09.007
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2799:
2766:Peripartum cardiomyopathy
2756:Pubic symphysis diastasis
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1369:10.1080/14767050600590573
1044:"Dermatoses of pregnancy"
938:10.1016/j.det.2018.02.012
722:"Dermatoses of Pregnancy"
152:Left side view of abdomen
151:
142:
137:
2292:Gestational hypertension
1917:10.1080/jmf.11.3.146.152
1042:Shornick, J. K. (2009).
606:Lambert, Julien (2016).
369:human choriogonadotropin
232:
2691:Umbilical cord prolapse
2613:Amniotic fluid embolism
2371:dermatoses of pregnancy
2807:Concomitant conditions
2786:Postpartum thyroiditis
2564:Circumvallate placenta
2384:Impetigo herpetiformis
2379:Gestational pemphigoid
2351:Hyperemesis gravidarum
2284:hypertensive disorders
1091:"Pregnancy dermatoses"
986:Clinics in Dermatology
920:Bechtel, Mark (2018).
373:pemphigoid gestationis
2776:Postpartum infections
2771:Postpartum depression
1468:(2): 53–58, quiz 59.
1139:Romm (January 2010).
337:Front view of abdomen
295:Inflammatory Mediated
257:Dermatological Causes
2781:Postpartum psychosis
2650:Obstetrical bleeding
2545:Obstetrical bleeding
2366:Integumentary system
2341:Gestational diabetes
2320:related to pregnancy
2318:Other, predominantly
2012:J Am Osteopath Assoc
1404:Dermatologic Therapy
926:Dermatologic Clinics
576:10.1067/mob.2003.129
349:Side view of abdomen
290:Immunological Causes
54:improve this article
2761:Postpartum bleeding
2584:Placental abruption
2569:Monochorionic twins
2399:Prurigo gestationis
1899:Källén, B. (2003).
1637:(9144): 1898–1901.
1585:10.1155/2015/979635
1101:(2 Pt 1): 233–241.
361:Feet and ankle view
2791:Puerperal mastitis
2746:Breast engorgement
2533:Monoamniotic twins
2523:Chorionic hematoma
2110:External resources
1717:Dehdashti (2015).
208:Signs and symptoms
2864:
2863:
2822:Thyroid disorders
2812:Diabetes mellitus
2696:Uterine inversion
2628:Shoulder dystocia
2623:Obstructed labour
2599:
2598:
2463:
2462:
2432:Chorea gravidarum
2208:Ectopic pregnancy
2133:
2132:
1966:(11): 1274–1280.
1821:10.1159/000473874
1416:10.1111/dth.12034
866:Dermatol (2012).
633:978-3-318-05888-8
624:10.1159/000446087
156:
155:
132:Medical condition
130:
129:
122:
104:
16:(Redirected from
2889:
2851:
2850:
2686:Postmature birth
2674:Placenta accreta
2579:Placenta praevia
2574:Placenta accreta
2518:Chorioamnionitis
2328:Digestive system
2324:
2323:
2250:Fetal resorption
2238:Rudimentary horn
2195:abortive outcome
2189:
2188:
2160:
2153:
2146:
2137:
2136:
2047:
2046:
2035:
2034:
2032:
2026:. Archived from
2009:
2000:
1994:
1993:
1975:
1960:JAMA Dermatology
1951:
1945:
1944:
1896:
1890:
1889:
1849:
1843:
1842:
1832:
1800:
1794:
1793:
1745:
1739:
1738:
1714:
1708:
1707:
1677:
1671:
1670:
1622:
1616:
1615:
1605:
1587:
1563:
1557:
1556:
1508:
1502:
1501:
1453:
1444:
1443:
1395:
1389:
1388:
1352:
1346:
1345:
1305:
1299:
1298:
1250:
1244:
1232:
1221:
1220:
1180:
1167:
1166:
1136:
1127:
1126:
1086:
1080:
1079:
1039:
1033:
1032:
1024:
1018:
1017:
977:
966:
965:
917:
906:
905:
887:
878:(9): 1047–1053.
863:
857:
856:
855:
853:
830:
817:
816:
776:
770:
769:
754:Am Fam Physician
749:
743:
742:
741:
740:
717:
704:
703:
655:
646:
645:
603:
597:
596:
578:
569:(4): 1083–1092.
554:
543:
542:
506:
500:
499:
471:
423:topical steroids
412:chlorpheniramine
358:
346:
334:
318:Immunoglobulin M
302:Langerhans cells
173:), is a chronic
147:
135:
134:
125:
118:
114:
111:
105:
103:
62:
38:
30:
21:
2897:
2896:
2892:
2891:
2890:
2888:
2887:
2886:
2867:
2866:
2865:
2860:
2838:
2795:
2739:Cracked nipples
2734:Low milk supply
2715:
2701:Uterine rupture
2595:
2490:Oligohydramnios
2475:amniotic cavity
2469:
2459:
2436:
2418:
2369:
2360:
2319:
2313:
2282:
2269:
2255:Molar pregnancy
2194:
2178:
2164:
2134:
2129:
2128:
2105:
2104:
2058:
2044:
2039:
2038:
2030:
2007:
2001:
1997:
1952:
1948:
1897:
1893:
1850:
1846:
1801:
1797:
1746:
1742:
1715:
1711:
1704:
1678:
1674:
1623:
1619:
1564:
1560:
1509:
1505:
1454:
1447:
1396:
1392:
1353:
1349:
1306:
1302:
1251:
1247:
1233:
1224:
1181:
1170:
1163:
1137:
1130:
1087:
1083:
1040:
1036:
1025:
1021:
978:
969:
918:
909:
864:
860:
851:
849:
831:
820:
777:
773:
750:
746:
738:
736:
718:
707:
656:
649:
634:
604:
600:
555:
546:
507:
503:
472:
465:
460:
443:
389:
362:
359:
350:
347:
338:
335:
326:
314:
297:
292:
271:
269:Hormonal Causes
259:
235:
210:
133:
126:
115:
109:
106:
63:
61:
51:
39:
28:
23:
22:
15:
12:
11:
5:
2895:
2885:
2884:
2879:
2862:
2861:
2859:
2858:
2843:
2840:
2839:
2837:
2836:
2831:
2829:Maternal death
2826:
2825:
2824:
2819:
2814:
2803:
2801:
2797:
2796:
2794:
2793:
2788:
2783:
2778:
2773:
2768:
2763:
2758:
2753:
2748:
2743:
2742:
2741:
2736:
2725:
2723:
2717:
2716:
2714:
2713:
2708:
2703:
2698:
2693:
2688:
2683:
2678:
2677:
2676:
2664:
2659:
2658:
2657:
2647:
2642:
2637:
2635:Fetal distress
2632:
2631:
2630:
2620:
2615:
2609:
2607:
2601:
2600:
2597:
2596:
2594:
2593:
2592:
2591:
2586:
2581:
2576:
2571:
2566:
2554:
2553:
2552:
2542:
2541:
2540:
2535:
2530:
2525:
2520:
2504:
2499:
2498:
2497:
2495:Polyhydramnios
2492:
2484:amniotic fluid
2479:
2477:
2465:
2464:
2461:
2460:
2458:
2457:
2452:
2446:
2444:
2438:
2437:
2435:
2434:
2428:
2426:
2424:Nervous system
2420:
2419:
2417:
2416:
2411:
2406:
2401:
2396:
2391:
2386:
2381:
2375:
2373:
2362:
2361:
2359:
2358:
2353:
2348:
2343:
2338:
2332:
2330:
2321:
2315:
2314:
2312:
2311:
2306:
2305:
2304:
2302:HELLP syndrome
2294:
2288:
2286:
2271:
2270:
2268:
2267:
2262:
2257:
2252:
2247:
2242:
2241:
2240:
2235:
2230:
2225:
2220:
2215:
2205:
2199:
2197:
2193:Pregnancy with
2186:
2180:
2179:
2163:
2162:
2155:
2148:
2140:
2131:
2130:
2127:
2126:
2114:
2113:
2111:
2107:
2106:
2103:
2102:
2091:
2080:
2059:
2054:
2053:
2051:
2050:Classification
2043:
2042:External links
2040:
2037:
2036:
2033:on 2007-09-27.
1995:
1946:
1911:(3): 146–152.
1891:
1864:(2): 157–159.
1844:
1815:(1): 151–156.
1795:
1760:(2): 137–140.
1740:
1729:(6): 344–347.
1709:
1702:
1672:
1617:
1558:
1523:(6): 642–648.
1503:
1445:
1410:(2): 157–167.
1390:
1347:
1320:(6): 933–939.
1300:
1245:
1222:
1168:
1161:
1128:
1081:
1054:(3): 172–181.
1034:
1019:
992:(3): 383–391.
967:
932:(3): 259–265.
907:
858:
818:
791:(3): 473–480.
771:
744:
705:
647:
632:
598:
544:
501:
462:
461:
459:
456:
455:
454:
449:
442:
439:
427:corticosteroid
388:
385:
364:
363:
360:
353:
351:
348:
341:
339:
336:
329:
325:
322:
313:
310:
296:
293:
291:
288:
270:
267:
258:
255:
234:
231:
209:
206:
154:
153:
149:
148:
140:
139:
131:
128:
127:
42:
40:
33:
26:
9:
6:
4:
3:
2:
2894:
2883:
2880:
2878:
2875:
2874:
2872:
2857:
2856:
2852:
2845:
2844:
2841:
2835:
2832:
2830:
2827:
2823:
2820:
2818:
2815:
2813:
2810:
2809:
2808:
2805:
2804:
2802:
2798:
2792:
2789:
2787:
2784:
2782:
2779:
2777:
2774:
2772:
2769:
2767:
2764:
2762:
2759:
2757:
2754:
2752:
2749:
2747:
2744:
2740:
2737:
2735:
2732:
2731:
2730:
2727:
2726:
2724:
2722:
2718:
2712:
2711:Uterine atony
2709:
2707:
2704:
2702:
2699:
2697:
2694:
2692:
2689:
2687:
2684:
2682:
2681:Preterm birth
2679:
2675:
2672:
2671:
2670:
2669:
2665:
2663:
2660:
2656:
2653:
2652:
2651:
2648:
2646:
2643:
2641:
2638:
2636:
2633:
2629:
2626:
2625:
2624:
2621:
2619:
2616:
2614:
2611:
2610:
2608:
2606:
2602:
2590:
2587:
2585:
2582:
2580:
2577:
2575:
2572:
2570:
2567:
2565:
2562:
2561:
2560:
2559:
2555:
2551:
2548:
2547:
2546:
2543:
2539:
2536:
2534:
2531:
2529:
2526:
2524:
2521:
2519:
2516:
2515:
2514:
2513:
2509:
2505:
2503:
2500:
2496:
2493:
2491:
2488:
2487:
2486:
2485:
2481:
2480:
2478:
2476:
2472:
2466:
2456:
2453:
2451:
2448:
2447:
2445:
2443:
2439:
2433:
2430:
2429:
2427:
2425:
2421:
2415:
2414:Stretch marks
2412:
2410:
2407:
2405:
2402:
2400:
2397:
2395:
2392:
2390:
2387:
2385:
2382:
2380:
2377:
2376:
2374:
2372:
2367:
2363:
2357:
2354:
2352:
2349:
2347:
2344:
2342:
2339:
2337:
2334:
2333:
2331:
2329:
2325:
2322:
2316:
2310:
2307:
2303:
2300:
2299:
2298:
2297:Pre-eclampsia
2295:
2293:
2290:
2289:
2287:
2285:
2280:
2276:
2272:
2266:
2263:
2261:
2258:
2256:
2253:
2251:
2248:
2246:
2243:
2239:
2236:
2234:
2231:
2229:
2226:
2224:
2221:
2219:
2216:
2214:
2211:
2210:
2209:
2206:
2204:
2201:
2200:
2198:
2196:
2190:
2187:
2185:
2181:
2177:
2173:
2169:
2166:Pathology of
2161:
2156:
2154:
2149:
2147:
2142:
2141:
2138:
2125:
2121:
2120:
2116:
2115:
2112:
2108:
2101:
2097:
2096:
2092:
2090:
2086:
2085:
2081:
2078:
2074:
2070:
2069:
2065:
2061:
2060:
2057:
2052:
2048:
2029:
2025:
2021:
2017:
2013:
2006:
1999:
1991:
1987:
1983:
1979:
1974:
1969:
1965:
1961:
1957:
1950:
1942:
1938:
1934:
1930:
1926:
1922:
1918:
1914:
1910:
1906:
1902:
1895:
1887:
1883:
1879:
1875:
1871:
1867:
1863:
1859:
1855:
1848:
1840:
1836:
1831:
1826:
1822:
1818:
1814:
1810:
1806:
1799:
1791:
1787:
1783:
1779:
1775:
1771:
1767:
1763:
1759:
1755:
1751:
1744:
1736:
1732:
1728:
1724:
1720:
1713:
1705:
1703:9780323485531
1699:
1695:
1691:
1687:
1683:
1676:
1668:
1664:
1660:
1656:
1652:
1648:
1644:
1640:
1636:
1632:
1628:
1621:
1613:
1609:
1604:
1599:
1595:
1591:
1586:
1581:
1577:
1573:
1569:
1562:
1554:
1550:
1546:
1542:
1538:
1534:
1530:
1526:
1522:
1518:
1514:
1507:
1499:
1495:
1491:
1487:
1483:
1479:
1475:
1471:
1467:
1463:
1459:
1452:
1450:
1441:
1437:
1433:
1429:
1425:
1421:
1417:
1413:
1409:
1405:
1401:
1394:
1386:
1382:
1378:
1374:
1370:
1366:
1362:
1358:
1351:
1343:
1339:
1335:
1331:
1327:
1323:
1319:
1315:
1311:
1304:
1296:
1292:
1288:
1284:
1280:
1276:
1272:
1268:
1264:
1260:
1256:
1249:
1243:
1239:
1238:
1231:
1229:
1227:
1218:
1214:
1210:
1206:
1202:
1198:
1194:
1190:
1186:
1179:
1177:
1175:
1173:
1164:
1162:9780443072772
1158:
1154:
1150:
1146:
1142:
1135:
1133:
1124:
1120:
1116:
1112:
1108:
1104:
1100:
1096:
1092:
1085:
1077:
1073:
1069:
1065:
1061:
1057:
1053:
1049:
1045:
1038:
1030:
1023:
1015:
1011:
1007:
1003:
999:
995:
991:
987:
983:
976:
974:
972:
963:
959:
955:
951:
947:
943:
939:
935:
931:
927:
923:
916:
914:
912:
903:
899:
895:
891:
886:
881:
877:
873:
869:
862:
848:
844:
840:
836:
829:
827:
825:
823:
814:
810:
806:
802:
798:
794:
790:
786:
782:
775:
767:
763:
759:
755:
748:
735:
731:
727:
723:
716:
714:
712:
710:
701:
697:
693:
689:
685:
681:
677:
673:
669:
665:
661:
654:
652:
643:
639:
635:
629:
625:
621:
617:
613:
609:
602:
594:
590:
586:
582:
577:
572:
568:
564:
560:
553:
551:
549:
540:
536:
532:
528:
524:
520:
517:(5): 378–81.
516:
512:
505:
497:
493:
489:
485:
481:
477:
476:Clin Dermatol
470:
468:
463:
453:
450:
448:
445:
444:
438:
435:
431:
428:
424:
419:
417:
413:
408:
405:
404:Antihistamine
401:
397:
393:
384:
380:
376:
374:
370:
357:
352:
345:
340:
333:
328:
327:
321:
319:
309:
305:
303:
287:
285:
281:
277:
266:
264:
254:
252:
247:
243:
241:
230:
226:
222:
220:
214:
205:
201:
197:
195:
190:
188:
184:
180:
176:
172:
168:
164:
160:
150:
146:
141:
136:
124:
121:
113:
110:February 2009
102:
99:
95:
92:
88:
85:
81:
78:
74:
71: –
70:
66:
65:Find sources:
59:
55:
49:
48:
43:This article
41:
37:
32:
31:
19:
2853:
2846:
2706:Vasa praevia
2666:
2640:Locked twins
2556:
2506:
2482:
2408:
2228:Interstitial
2117:
2093:
2082:
2062:
2028:the original
2015:
2011:
1998:
1963:
1959:
1949:
1908:
1904:
1894:
1861:
1857:
1847:
1812:
1808:
1803:Kim (2017).
1798:
1757:
1753:
1743:
1726:
1722:
1712:
1685:
1675:
1634:
1630:
1620:
1575:
1571:
1561:
1520:
1516:
1506:
1465:
1461:
1407:
1403:
1393:
1363:(5): 305–8.
1360:
1356:
1350:
1317:
1313:
1303:
1262:
1258:
1248:
1235:
1195:(1): 44–48.
1192:
1188:
1144:
1098:
1094:
1084:
1051:
1047:
1037:
1022:
989:
985:
929:
925:
875:
871:
861:
850:, retrieved
838:
788:
784:
774:
760:(2): 211–8.
757:
753:
747:
737:, retrieved
725:
670:(1): 25–41.
667:
663:
615:
611:
601:
566:
562:
514:
510:
504:
482:(2): 105–8.
479:
475:
436:
432:
420:
409:
402:
398:
394:
390:
381:
377:
365:
315:
306:
298:
280:progesterone
272:
260:
251:hypertension
248:
244:
236:
227:
223:
215:
211:
202:
198:
191:
170:
166:
162:
158:
157:
116:
107:
97:
90:
83:
76:
64:
52:Please help
47:verification
44:
2645:Nuchal cord
2394:Linea nigra
2346:Hepatitis E
2279:proteinuria
2260:Miscarriage
2245:Embryo loss
2223:Heterotopic
2018:(1): 44–6.
618:: 164–172.
308:pregnancy.
2871:Categories
2655:Postpartum
2550:Antepartum
2265:Stillbirth
2176:puerperium
2174:, and the
2172:childbirth
2095:DiseasesDB
1578:: 979635.
1265:(1): 1–5.
839:StatPearls
739:2021-08-02
726:StatPearls
458:References
312:Autoimmune
276:gestations
187:dermatoses
80:newspapers
2721:Puerperal
2309:Eclampsia
2213:Abdominal
2184:Pregnancy
2168:pregnancy
2119:eMedicine
1982:2168-6084
1925:1476-7058
1878:1081-1206
1774:1364-6893
1651:0140-6736
1594:1687-6105
1537:0011-9059
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