Pruritic urticarial papule and plaque disease of pregnancy
Introduction
Introduction to pruritic urticaria and plaque in pregnancy Pregnancy pruritic urticaria papulosis and plaque disease is a severe pruritic skin disease that often occurs in the end of primipara pregnancy. It is a common skin condition during pregnancy and the incidence is about 1 in 200. The typical feature is red, and the itchy mass is distributed along the tension line in the abdomen, usually in the middle and late stages of pregnancy. Natural relief within a few weeks after delivery does not affect the health of the mother and the baby. The primipara is common and rare after that. basic knowledge Sickness ratio: 0.00052% Susceptible population: primipara Mode of infection: non-infectious Complications: herpes-like pemphigus
Cause
Pregnancy pruritic urticaria papulosis and plaque cause
(1) Causes of the disease
The etiology has not yet been clarified. The skin damage, clinical and histology of this disease are similar to urticaria and polymorphous erythema-like reactions. It may be related to an allergic reaction of unexplained factors in pregnant women, first appearing in the abdomen, usually around the umbilicus. Later, it spreads to the thighs and the extremities of the limbs, often in the third trimester of pregnancy, which may be related to changes in the skin caused by over-expansion of the abdomen (the fetal weight gains too fast or multiple pregnancies).
(two) pathogenesis
The pathological changes of the skin of the disease are not specific, the epidermis and upper part of the dermis are edematous, superficial perivascular mild non-specific lymphocytes and histiocytes are infiltrated, and there are a small amount of eosinophils, although white blood cell fragmentation can be seen, There is no real vasculitis. In some cases, there are focal sponge formation and parakeratosis, sponge-forming vesicles, and some cases have no obvious pathological changes.
Prevention
Pregnancy pruritic urticaria papules and plaque prevention
There are no effective preventive measures for this disease. Pay attention to health, do a good job of safety protection, reduce and avoid the irritating and accidental injury of adverse factors, can play a certain preventive role; In addition, early detection, early diagnosis and early treatment are also the key to prevention and treatment of this disease. In case of onset, active treatment should be actively treated to prevent complications.
Complication
Pregnancy pruritic urticaria and plaque complications Complications herpes-like pemphigus
There are few pregnant women and fetal complications in this disease. In some cases, there are focal sponge formation and parakeratosis, sponge-forming blisters, and some cases have no obvious pathological changes.
Symptom
Symptoms of pruritic urticaria and plaque in pregnancy Common symptoms Skin itching, pimples, herpes, urticaria...
PUPPP first appeared in the abdomen, usually at the umbilical circumference, but the umbilicus was generally not affected. PUPPP was initially expressed as many edematous red papules with a diameter of 1 to 2 mm. Some patients also developed herpes, which was carefully examined. A pale circle can be found around these lesions, after which the skin lesions can fuse into urticaria plaques and involve most of the skin in the abdomen. After a few days, the skin lesions often spread to the lower torso, buttocks, thighs and extremities, but the breasts And the face is rarely involved, often accompanied by intense itching during the spread of the rash, and affects sleep, but also the reason for patients to seek medical care, although accompanied by itching, but scratches are not common.
Examine
Examination of pruritic urticaria papules and plaque in pregnancy
Including hematuria, blood biochemistry, liver function, human chorionic gonadotropin, estrogen and progesterone values are in the normal range. The skin lesions and surrounding skin directly fluorescein IgG, IgM and complement C3 are negative.
Diagnosis
Diagnosis and diagnosis of pruritic urticaria and plaque in pregnancy
The diagnosis of PUPPP is mainly based on typical clinical manifestations. If there is severe itchy papules and plaques in the umbilical expansion at the beginning of the first trimester, and the trunk, buttocks and thighs are involved, the diagnosis can be confirmed.
It should be differentiated from gestational papular dermatitis. The latter lesions are characterized by small papules, no wheal plaques, increased chorioalcoholic gonadotropin and decreased estriol levels. In addition, early lesions should be associated with early pregnancy herpes. The genital papules were identified. The direct immunofluorescence showed that complement C3 was deposited linearly along the basement membrane, but no immunoglobulin or complement C3 was found in the skin of this disease.
