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Diagnostic Pitfall in Atypical Febrile Presentation in a Patient with a Pregnancy-Specific Dermatosis—Case Report and Literature Review

Pruritic urticarial papules and plaques of pregnancy (PUPPP) usually occurs in the third trimester of pregnancy in primiparous women. It is a self-limiting inflammatory disorder with a still unknown pathogenic mechanism. The abdominal wall overdistension, with a subsequent inflammatory response due...

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Autores principales: Mehedintu, Claudia, Isopescu, Florin, Ionescu, Oana-Maria, Petca, Aida, Bratila, Elvira, Cirstoiu, Monica Mihaela, Carp-Veliscu, Andreea, Frincu, Francesca
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9315689/
https://www.ncbi.nlm.nih.gov/pubmed/35888566
http://dx.doi.org/10.3390/medicina58070847
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author Mehedintu, Claudia
Isopescu, Florin
Ionescu, Oana-Maria
Petca, Aida
Bratila, Elvira
Cirstoiu, Monica Mihaela
Carp-Veliscu, Andreea
Frincu, Francesca
author_facet Mehedintu, Claudia
Isopescu, Florin
Ionescu, Oana-Maria
Petca, Aida
Bratila, Elvira
Cirstoiu, Monica Mihaela
Carp-Veliscu, Andreea
Frincu, Francesca
author_sort Mehedintu, Claudia
collection PubMed
description Pruritic urticarial papules and plaques of pregnancy (PUPPP) usually occurs in the third trimester of pregnancy in primiparous women. It is a self-limiting inflammatory disorder with a still unknown pathogenic mechanism. The abdominal wall overdistension, with a subsequent inflammatory response due to damage to the connective tissue, represents a pathogenesis explanation. Clinical features involve intensely pruritic urticarial rash with edematous, erythematous papules and plaques. The clinical picture and dermal biopsy establish the diagnosis. Topical corticosteroids and oral antihistamines are usually sufficient, but sometimes systemic corticosteroids are necessary. Maternal and fetal prognosis is excellent, and the lesions resolve after birth with no scarring or pigmentary change. We present a case of a 36-year-old patient with a 32-week pregnancy who was admitted with a generalized pruritic rash accompanied by fever. The final diagnosis was decided after multiple pathology exclusions. Treatment consisted of systemic corticoid therapy. The patient gave birth by cesarean section to a healthy newborn without dermatological lesions or other conditions. Adding more PUPPP cases to the literature portfolio will bring more awareness to this under-recognized and under-reported skin disorder. We trust this case will encourage other physicians to publish more cases of pregnancy-specific dermatoses.
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spelling pubmed-93156892022-07-27 Diagnostic Pitfall in Atypical Febrile Presentation in a Patient with a Pregnancy-Specific Dermatosis—Case Report and Literature Review Mehedintu, Claudia Isopescu, Florin Ionescu, Oana-Maria Petca, Aida Bratila, Elvira Cirstoiu, Monica Mihaela Carp-Veliscu, Andreea Frincu, Francesca Medicina (Kaunas) Case Report Pruritic urticarial papules and plaques of pregnancy (PUPPP) usually occurs in the third trimester of pregnancy in primiparous women. It is a self-limiting inflammatory disorder with a still unknown pathogenic mechanism. The abdominal wall overdistension, with a subsequent inflammatory response due to damage to the connective tissue, represents a pathogenesis explanation. Clinical features involve intensely pruritic urticarial rash with edematous, erythematous papules and plaques. The clinical picture and dermal biopsy establish the diagnosis. Topical corticosteroids and oral antihistamines are usually sufficient, but sometimes systemic corticosteroids are necessary. Maternal and fetal prognosis is excellent, and the lesions resolve after birth with no scarring or pigmentary change. We present a case of a 36-year-old patient with a 32-week pregnancy who was admitted with a generalized pruritic rash accompanied by fever. The final diagnosis was decided after multiple pathology exclusions. Treatment consisted of systemic corticoid therapy. The patient gave birth by cesarean section to a healthy newborn without dermatological lesions or other conditions. Adding more PUPPP cases to the literature portfolio will bring more awareness to this under-recognized and under-reported skin disorder. We trust this case will encourage other physicians to publish more cases of pregnancy-specific dermatoses. MDPI 2022-06-25 /pmc/articles/PMC9315689/ /pubmed/35888566 http://dx.doi.org/10.3390/medicina58070847 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Mehedintu, Claudia
Isopescu, Florin
Ionescu, Oana-Maria
Petca, Aida
Bratila, Elvira
Cirstoiu, Monica Mihaela
Carp-Veliscu, Andreea
Frincu, Francesca
Diagnostic Pitfall in Atypical Febrile Presentation in a Patient with a Pregnancy-Specific Dermatosis—Case Report and Literature Review
title Diagnostic Pitfall in Atypical Febrile Presentation in a Patient with a Pregnancy-Specific Dermatosis—Case Report and Literature Review
title_full Diagnostic Pitfall in Atypical Febrile Presentation in a Patient with a Pregnancy-Specific Dermatosis—Case Report and Literature Review
title_fullStr Diagnostic Pitfall in Atypical Febrile Presentation in a Patient with a Pregnancy-Specific Dermatosis—Case Report and Literature Review
title_full_unstemmed Diagnostic Pitfall in Atypical Febrile Presentation in a Patient with a Pregnancy-Specific Dermatosis—Case Report and Literature Review
title_short Diagnostic Pitfall in Atypical Febrile Presentation in a Patient with a Pregnancy-Specific Dermatosis—Case Report and Literature Review
title_sort diagnostic pitfall in atypical febrile presentation in a patient with a pregnancy-specific dermatosis—case report and literature review
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9315689/
https://www.ncbi.nlm.nih.gov/pubmed/35888566
http://dx.doi.org/10.3390/medicina58070847
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