What causes skin rash during pregnancy?
Patient: Hello, my wife who is pregnant 12 weeks tomorrow (First pregnancy and no health concerns) has developed a rash over the last 3 weeks. We initially suspected that she had an allergy to a body cream but it has persisted. It initially began as an oval shapped (almost scratch like) mark on the side of her upper body near the above the love handles and now has burst into a rash all over her abdomen, breasts and a few on the back. We have gone to a dertmatoligist and she has diagnosed Pityriasis Rosea. 2 Questions, I have done research online and only found 1 study showing that it increases the risk of miscarriage and may cause mobility issues or strength issues in the muscles as an infant that can be overcome. Are there any other more concrete studies showing the effects of this and what is your experience with this virus amongst pregnant women? The second question is what are the differences in symptoms of Pityriasis Rosea and PUPPP? Doctor: Hello there, thanks for your query. Your efforts in researching for scientific literature is commendable. As you have rightly found out there are not much studies regarding pityriasis rosea in pregnancy. Those reports suggest possible miscarriage, premature delivery, movement issues in the baby. It is very difficult to draw conclusions from a single study which includes a very limited number of patients and hence the inference cannot be generalised. What one can do in such a circumstance is adopt a wait and watch policy and take adequate precautions to prevent miscarriage and preterm delivery. And undergo a detailed genetic sonogram (anomaly scan) to rule out structural defects in the baby. It usually starts as a single oval patch with well demarcated red boundary and central pink region which over 2 weeks spreads to trunk, back, neck and extremities and they are oval raised lesions which would look like Christmas tree. It spares face, feet and palms. Whereas puppp is seen in the last trimester of pregnancy and seen as papules along lines of striae over abdomen and thighs and it gets intensely itchy. It is most likely related to stretching of the skin. I would like to add that i have given gross features  of PR and it should not be used to diagnose the lesion by oneself. Pityriasis rosea should be diagnosed by a trained dermatologist who does job at their best and the management in pregnancy should be a team work comprising of your obstetrician and dermatologist and a good radiologist.Hope this information is helpful to you. Take care.