Medication Summary
As previously mentioned, topical corticosteroids are the mainstay of treatment for polymorphic eruption of pregnancy (PEP). [23] Symptom alleviation may require high-potency topical (class I or II) steroids, such as fluocinonide, or even systemic steroids. Oral antihistamines are only mildly effective.
Diphenhydramine, an antihistamine, has a sedative effect that may help patients to sleep better; it is also an effective agent against pruritus resulting from histamine release during inflammatory reactions.
Medications may need to be used into the postpartum period. Pay attention to potential adverse effects with breastfeeding.
Corticosteroids
Class Summary
Corticosteroids have anti-inflammatory properties and cause profound and varied metabolic effects. In addition, these agents modify the body's immune response to diverse stimuli. Use systemic steroids for severe, refractory cases only.
Fluocinonide (Vanos)
Fluocinonide is a class II, high-potency, topical corticosteroid that inhibits cell proliferation. It is immunosuppressive and anti-inflammatory.
Fluticasone (Cutivate)
Fluticasone is a high-potency, topical corticosteroid that inhibits cell proliferation. It is immunosuppressive and anti-inflammatory.
Prednisone
Prednisone may decrease inflammation by reversing increased capillary permeability and suppressing polymorphonuclear leukocyte activity.
Prednisolone (Pediapred, Orapred, Flo-Pred)
This glucocorticosteroid occurs naturally and synthetically. It is used for both acute and chronic asthma. It may decrease inflammation by reversing increased capillary permeability and suppressing polymorphonuclear leukocyte activity.
Antihistamines, 1st Generation
Class Summary
Antihistamines have a sedative effect that may improve sleep.
Diphenhydramine (Benadryl, Diphenhist, Allerdryl)
Diphenhydramine is used for the symptomatic relief of pruritus caused by the release of histamine in inflammatory reactions.
Hydroxyzine (Vistaril)
Hydroxyzine antagonizes H1 receptors in the periphery. It may suppress histamine activity and subsequently cause relieve of pruritus.
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Papules within prominent striae distensae. Courtesy of Jeffrey P. Callen, MD of Louisville, Kentucky.
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Papules within prominent striae distensae. Courtesy of Jeffrey P. Callen, MD of Louisville, Kentucky.
