Q&A: What's the treatment for PUPPS?

by Dr. Gerard M. DiLeo

I have been diagnosed with PUPPS. My OB tried a round of steroid medicine to see if that would help - it did not. I am only 25 weeks pregnant and this rash is already all over my belly and breasts. I need help dealing with this for the next three months. I have tried Benadryl (no help) and Sarna Lotion. I am having to sleep with an ice pack to numb my skin from the burning itch.

Do you have any suggestions? I'm miserable and am getting less than four hours of interruped sleep every night. My OB will probably be sending me to a dermatologist but from what I have read, steroid cremes are not very effective either. Please help me, I will try anything.

No one knows what causes Puerperal Urticaria of Pregnancy, but some theorize it is fetal cells getting into your circulation, landing at the ends of little arterioles and attracting a foreign body reaction. Whatever it is, it does seem to be immunological in nature.

I have no magic answers, all I can tell you is what I did for a patient who came down with a bad case of it. I ended up putting her on Medrol dose packs, almost continuously by the end of the pregnancy. This is drastic, although she and her baby did fine. I would only do that in consultation with a maternal-fetal specialist. Good luck on a very troubling, but harmless, condition.

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