At 34 weeks of a first twin pregnancy, intensely pruritic urticated papules begin within abdominal striae and spread to the thighs. The umbilicus,

Question

At 34 weeks of a first twin pregnancy, intensely pruritic urticated papules begin within abdominal striae and spread to the thighs. The umbilicus, mucosae, palms and soles are spared and there are no tense blisters. What is the best diagnosis and initial approach?

Accepted Answer

Polymorphic eruption of pregnancy; use topical corticosteroid and a suitable antihistamine

Answer

Intrahepatic cholestasis; diagnose from the rash morphology without checking liver tests or bile acids

Answer

Atopic eruption of pregnancy; start methotrexate because onset in the third trimester predicts persistence

Answer

Pemphigoid gestationis; commence rituximab before performing any confirmatory investigation

Answer

Pustular psoriasis of pregnancy; admit for systemic assessment and ciclosporin treatment

Polymorphic Eruption of Pregnancy — SCE Dermatology MCQ

At 34 weeks of a first twin pregnancy, intensely pruritic urticated papules begin within abdominal striae and spread to the thighs. The umbilicus, mucosae, palms and soles are spared and there are no tense blisters. What is the best diagnosis and initial approach?