06-29-2011, 06:44 AM
ans D
Explanation from archer q bank
PUPP (Pruritic Urticarial Papules of Pregnancy) also known as polymorphic eruption of pregnancy is the most common rash in pregnant women. It normally occurs in first pregnancies during the third trimester with an average onset of 35 weeks. Recurrence in subsequent pregnancies is uncommon. The classic rash begins as papules or wheals in the abdominal striae and coalesces to form plaques. Assocaited with severe pruritis. There is sparing of peri-umbilical skin which helps in clinically distinguishing it from Pemphigoid Gestationis. Rx is with topical corticosteroid.
Presence of typical rash starting in abdominal striae helps in differentiating it from ICP. ICP is characterized by pruritis without any rash and increased serum bile acids. Excoriations may be present due to scratching but not the typical rash as described in the question.
Pemphigoid Gestationis can occur in second or third trimester and is associated with urticarial papules or plaques. It may later develop in to bullae. In the early stages, it may closely resemble PUPP. However, the rash in Pemphigoid Gestationis often begins in the peri-umbilical area where as in PUPP; the rash begins in the abdominal straie and often, spares the peri-umbilical area.
The clinical presentation is not consistent with scabies. There is a history of affected family members in scabies and the distribution of rash is often, in the finger webs, palms and soles.
Pruritic folliculitis of pregnancy is a rare atopic dermatitis of pregnancy and is characterized by intensely itchy, sterile eruption with follicular distribution.
Explanation from archer q bank
PUPP (Pruritic Urticarial Papules of Pregnancy) also known as polymorphic eruption of pregnancy is the most common rash in pregnant women. It normally occurs in first pregnancies during the third trimester with an average onset of 35 weeks. Recurrence in subsequent pregnancies is uncommon. The classic rash begins as papules or wheals in the abdominal striae and coalesces to form plaques. Assocaited with severe pruritis. There is sparing of peri-umbilical skin which helps in clinically distinguishing it from Pemphigoid Gestationis. Rx is with topical corticosteroid.
Presence of typical rash starting in abdominal striae helps in differentiating it from ICP. ICP is characterized by pruritis without any rash and increased serum bile acids. Excoriations may be present due to scratching but not the typical rash as described in the question.
Pemphigoid Gestationis can occur in second or third trimester and is associated with urticarial papules or plaques. It may later develop in to bullae. In the early stages, it may closely resemble PUPP. However, the rash in Pemphigoid Gestationis often begins in the peri-umbilical area where as in PUPP; the rash begins in the abdominal straie and often, spares the peri-umbilical area.
The clinical presentation is not consistent with scabies. There is a history of affected family members in scabies and the distribution of rash is often, in the finger webs, palms and soles.
Pruritic folliculitis of pregnancy is a rare atopic dermatitis of pregnancy and is characterized by intensely itchy, sterile eruption with follicular distribution.