Pruritic urticarial papules and plaques of pregnancy in twin and triplet pregnancies

Abstract

Pruritic urticarial papules and plaques of pregnancy (PUPPP) is a common dermatosis of unknown aetiology. Multiple pregnancies occur frequently in most reported series of PUPPP and increased abdominal distension has been considered a factor in its causation. To determine the frequency of PUPPP in twin and triplet pregnancies. A retrospective review of all the records of patients delivered of twin or triplet pregnancies over an 18-month period at a busy general maternity hospital. One hundred and thirty-eight women delivered twins, four of whom developed PUPPP (2.9%). Fourteen women delivered triplet pregnancies, two of whom developed PUPPP (14%). Four of these six multiple pregnancies were conceived by in vitro fertilization. The reported rate of PUPPP in single pregnancies is 1 in 200 (0.5%). Our findings suggest that multiple pregnancies are at a higher risk of developing this cutaneous eruption with 2.9% of twin and 14% of triplet pregnancies affected in our study.