Beyond the striae: an atypical case of polymorphic eruption of pregnancy with vasculitic features

Gautam K. Singh; Anshu Baghel; Vidyadhar R. Sardesai; Anil H. Patki

doi:10.18203/2320-1770.ijrcog20251608

Authors

Gautam K. Singh Department of Dermatology, Venereology and Leprosy, Bharati Vidyapeeth Medical College and Bharati Hospital, Pune, Maharashtra, India https://orcid.org/0000-0003-2708-7655
Anshu Baghel Department of Dermatology, Venereology and Leprosy, Bharati Vidyapeeth Medical College and Bharati Hospital, Pune, Maharashtra, India https://orcid.org/0009-0004-4760-5012
Vidyadhar R. Sardesai Department of Dermatology, Venereology and Leprosy, Bharati Vidyapeeth Medical College and Bharati Hospital, Pune, Maharashtra, India https://orcid.org/0000-0002-0064-731X
Anil H. Patki Department of Dermatology, Venereology and Leprosy, Bharati Vidyapeeth Medical College and Bharati Hospital, Pune, Maharashtra, India https://orcid.org/0009-0004-0067-5371

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20251608

Keywords:

Polymorphic eruption of pregnancy, Atypical PEP presentation, Pregnancy dermatoses

Abstract

Polymorphic eruption of pregnancy (PEP), also known as pruritic urticarial papules and plaques of pregnancy (PUPPP), is the most common benign dermatosis of pregnancy. We report a case of a 26-year-old primigravida at 32 weeks gestation who developed an extensive pruritic rash initially on the abdomen and later spreading to the extremities, back, flanks, and palms, palpable purpura was observed on the lower extremities, suggesting a vasculitic component. Skin biopsy revealed features of both PEP and leukocytoclastic vasculitis, while direct immunofluorescence for IgA was negative. The patient was managed conservatively with complete recovery. This case highlights a rare presentation of PEP with vasculitic features, necessitating careful evaluation. Further research is needed to explore possible triggers, including immune mechanisms or viral associations, to refine diagnostic criteria and optimize management strategies.

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