To the Editor.—
Pruritic urticarial plaques and papules of pregnancy (PUPPP) is a distinct dermatosis of pregnancy that has recently been associated with abdominal skin distention.1 We describe two cases, a triplet pregnancy and a case of polyhydramnios, that support this association. These are the first reported cases of PUPPP associated with in vitro fertilization.
Report of Cases.—Case 1.—
A 36-year-old woman (gravida 1, para 0) carrying triplets who were the result of in vitro fertilization developed an intensely pruritic rash over her abdomen during the 35th week of pregnancy. The rash started in the striae of her abdomen and spread to cover her inner arms, ankles, and wrists with urticarial plaques. The rash was treated with topical steroids.She went into labor the day of her dermatology consultation and was delivered of healthy triplets by cesarean section. The infants had no skin lesions. A skin biopsy