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Papular dermatitis of pregnancyO26.4
Synonym(s)
HistoryThis section has been translated automatically.
DefinitionThis section has been translated automatically.
Rare, controversial entity associated with pruritic papules (purigoform) pregnancy dermatosis (see below pregnancy, skin lesions).
Remark: possibly a chronic prurigo in pregnancy was described by AS Spangler.
Occurrence/EpidemiologyThis section has been translated automatically.
Apparently very rare; one disease on 2500 pregnancies (?).
LocalizationThis section has been translated automatically.
Clinical featuresThis section has been translated automatically.
Recurrent eruptions of intensely pruritic, prurigo-like papules, hemorrhagic crusting, pigmentation.
LaboratoryThis section has been translated automatically.
Differential diagnosisThis section has been translated automatically.
- PUPPP and other pregnancy dermatoses.
- Prurigo nodularis
- Pruriginous atopic dermatitis
Complication(s)This section has been translated automatically.
External therapyThis section has been translated automatically.
Initially, try blanching lotion alba (or ethanolic zinc oxide shake mixture R292 ), emulsions or gels. Cooling gels free of active agents temporarily alleviate the itching. Likewise, cool showers, "cool packs" or moist compresses, e.g. with 0.9% NaCl solution, bring relief.
If not sufficient, antipruriginous additives like polidocanol 3-5% (e.g. Thesit, R200, R197, Optiderm) or tannin 3-5% R247 in lotio alba. Next step are glucocorticoid-containing emulsions like 0,5% hydrocortisone emulsion (e.g. Hydrogalen, R123 ) or hydrocortisone in a cream base (e.g. Hydro Wolff or Hydrophilic Hydrocortisone Acetate Cream NRF11.15.).
Internal therapyThis section has been translated automatically.
In severe and intolerable pruritus with significant sleep disturbances, glucocorticoids such as prednisone (e.g. Decortin) 20-40 mg/day with gradual dose reduction according to clinical findings. In severe cases and in the last weeks of pregnancy, additional administration of diphenhydramine HCl(e.g. Vivinox 25-50 mg/day) or benzodiazepines (e.g. diazepam 2-5 mg/day).
The administration of antihistamines in pregnancy is assessed differently in the literature. However, at most preparations of the 1st generation such as clemastine (e.g. Tavegil 2 times/day 1 tbl. p.o. or 2 times/day 1 amp. i.v.) or hydroxyzine (e.g. Atarax 1-3 tbl./day) come into question.
Progression/forecastThis section has been translated automatically.
Healing after delivery, recurrence in subsequent pregnancies.
LiteratureThis section has been translated automatically.
- Black MM (1989). Prurigo of pregnancy, papular dermatitis of pregnancy, and pruritic folliculitis of pregnancy. Semin Dermatol 8:23-25.
- Michaud et al (1982) Papular dermatitis of pregnancy. Arch Dermatol 118: 1003
- Moses S (2003) Pruritus. Am Fam Physician 68: 1135-1142
- Nguyen LQ et al (1990) Papular dermatitis of pregnancy: a case report. J Am Acad Dermatol 22: 690-691
- Spangler AS, Reddy W, Bardawil WA, Roby CC, Emerson K (1962) Papular dermatitis of pregnancy. A new clinical entity? JAMA 181: 577-581