Polymorphic eruption of pregnancy

A report describes a case of a 26-year-old woman G1P0A0 at 37+2 weeks with twin gestation presented with a 4-day history of pruritic erythematous- papules and plaques starting initially on the abdomen, which spread rapidly over the lower extremities, buttocks, and chest, sparing Palms, soles and periumbilical areas.

Examinations revealed no fetal distress or systemic maternal symptoms. Due to obstetric indications, the patient delivered two healthy female babies weighing 2660 gr and 2260 gr by cesarean section within 38+5 days. She received proper antenatal care and denied any previous skin lesions, including infection with the herpes simplex virus. 

Physical examination showed multiple erythematous papules that appeared initially in the stretch marks of the abdomen, sparing the periumbilical area. But in the following days, it spread to the back and buttocks and the lower extremities with the appearance of large redurticated confluent plaques. However, it spared the upper extremities, palms, soles, and periumbilical areas. Genital mucosa was also not involved. 

Her Complete blood count, as well as all complete metabolic panels, remained within normal reference values. The dermatologist did not advise skin biopsy with immunohistochemical and immunofluorescence studies in this case. She received treatment with topical corticosteroids and general treatment measures and showed a positive clinical response. 

The patient received a discharge on the fifth postoperative day in good condition. She experienced complete resolution of dermatologic changes four weeks postpartum.

Zejnullahu VA, Zejnullahu VA. Polymorphic eruption of pregnancy. Dermatology Reports 2023;15:9546