Approach Considerations
Treatment is directed at relieving the pruritus associated with polymorphic eruption of pregnancy (PEP). Topical corticosteroids are the mainstay of treatment. [23] High-potency topical (class I or II), or even systemic, steroids may be required to alleviate symptoms. Oral antihistamines are only mildly effective.
General treatment measures include the use of cool, soothing baths; emollients; wet soaks; and light cotton clothing. PEP tends to resolve spontaneously shortly after delivery. Morbidity is not increased for the fetus born to an affected mother. An older case report described early cesarean delivery to relieve a severe case of PEP. [24]
For patients who strive to avoid the use of any medications when pregnant or breastfeeding, PEP has been successfully treated with intramuscular injection of autologous whole blood in three cases. [25]
PEP typically resolve within 4-6 weeks, independent of delivery. [6] Continue symptomatic care until resolution.
Consultations
The healthcare provider responsible for the patient's obstetric care should be made aware of the diagnosis, treatment, and favorable prognosis of PEP.
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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.
