Several skin rashes that occur during pregnancy are abnormal and potentially harmful to the fetus. Whenever an unusual rash occurs in pregnancy, medical attention should be sought as soon as possible. Some of these rashes may be harmful to the fetus.
Pruritic Urticarial Papules and Plaques of Pregnancy
Also known as polymorphic eruption of pregnancy, PUPPP is an intensely itchy rash that starts as small individual papules and spreads to become large patchy areas of redness resembling hives. It usually occurs in the third trimester of pregnancy in about 0.5 to 1 percent of pregnant women, then resolves upon delivery. PUPPP doesn't affect the baby. The cause of PUPPP is unknown. Because this rash is self-limiting, it's not necessary to treat it with antihistamine or corticosteroid creams, but if the itching becomes too intense, application of these creams may help. However, even topical medicine may carry some risk to the baby. Oatmeal baths and aloe vera lotion may help soothe the itch and will not harm the fetus.
Impetigo herpetiformis is an uncommon nonitchy rash that starts as a small area of pustules, or small pus-filled bumps, in the groin and inner thigh areas. The pustules may spread to other areas of the body, with the exception of the hands, feet and face. A pregnant woman with impetigo herpetiformis may experience nausea, vomiting, diarrhea, fever, chills and enlarged lymph glands. Complications such as bacterial infection, blood poisoning, and high levels of parathyroid hormone may occur. This condition may be either a pregnancy-induced skin infection or a form of pustular psoriasis made worse by pregnancy in women with a history of psoriasis. Experts have not decided whether impetigo herpetiformis causes harm to the fetus, but some believe it increases risk of placental insufficiency and stillbirth. Pregnant women with this disorder should therefore be treated aggressively and monitored closely. Impetigo herpetiformis is treated with high-strength corticosteroid cream, followed by the same cream in a lower strength as soon as the rash is under control.
Prurigo of Pregnancy
Prurigo occurs in 1 in 300 pregnancies. The rash is characterized by tiny itchy bumps that may resemble insect bites. They are likely to occur anywhere on the skin. The cause of the condition is unknown, but it doesn't appear to cause any maternal or fetal harm. No treatment is necessary other than oatmeal baths and aloe vera gel. However, if itching is too intense, mild antihistamines or corticosteroid cream may be used.
Pemphigoid gestationis, sometimes referred to as herpes gestationis, is a symptom of an autoimmune disorder that affects 1 in 50,000 pregnancies. Symptoms include red, itchy blisters around the belly button or on the arms and legs. Pemphigoid gestationis usually occurs during the second or third trimester of pregnancy but may linger as long as 6 weeks after delivery. As with other autoimmune disorders, this condition is caused by the body's own antibodies attacking itself. Of infants born to mothers with pemphigoid gestationis, 5 percent to 10 percent are born with some sort of rash. The condition is treated with oral antihistamines or with topical or oral corticosteroids.
Rash from pruritic folliculitis may occur in the second or third trimester of pregnancy. The rash consists of reddish papules and pustules in hair follicles on the abdomen, arms, back and chest. There doesn't seem to be any danger to the fetus from this rash. Treatment includes corticosteroid or benzoyl peroxide cream and UVB light therapy.