Severe Polymorphic Eruption of Pregnancy Developing in A Late Term Primigravida: A Case Report and Review of Literature

Background: Polymorphic eruption of pregnancy [PEP] is a benign inflammatory dermatosis of pregnancy of unknown etiology developing in the third trimester as an intensely pruritic rash and inflamed striae with peri-umbilical sparing. It is a self-limiting condition which resolves after delivery and has no maternal or fetal adverse effects. There are no specific investigations. Diagnosis is based on history and typical clinical features. Emollients, topical corticosteroids and oral antihistamines provide symptomatic relief, though a few patients with severe symptoms may require a short course of oral or injectable corticosteroids. Autologous hemotherapy is a safe option and can be considered in severe conditions. Case summary: This report describes an unusual patient with singleton pregnancy presenting at 41 weeks gestation with sudden onset intense itching and rash on abdomen, upper part of legs and arms. We have summarized current literature related to PEP and evaluated the variations in clinical presentations, relevant etiopathogenesis and treatment options.