Though the rash and pruritus typically disappear within 15 days after delivery even without therapy, women often seek treatment for symptomatic relief due to the intense itching. Topical corticosteroids are considered the first line of treatment for PUPPP in cases when the itching is localized, sometimes in conjunction with oral antihistamines . For patients with a widespread, intensely pruritic rash or those with inadequate response to topical therapy, a short course of systemic glucocorticoids may be prescribed. Other treatments which may provide symptomatic relief include the use of cool, wet compresses and oatmeal baths.
Tests: Common tests include blood tests for nutritional or sickle cell anemia, blood type and Rh factor, rubella titers, syphilis, and serum alpha-fetoprotein for the presence of neural tube defects such as spina bifida. Additional testing may include determining HIV status and hepatitis immunity. Ultrasound may be used to determine age, rate of growth, position, some birth defects, and fetal sex. Chorionic villus sampling may be done early in pregnancy if the family history indicates potential for genetic diseases. Second trimester amniocentesis may be used to detect chromosomal abnormalities, genetic disorders, and fetal sex. In late pregnancy, nonstress tests, contraction stress tests, and fetal biophysical profiles may be done; amniocentesis may be done to evaluate fetal lung maturity. See: table
There is little research on the impact of psoriasis and psoriatic arthritis treatments on pregnant and nursing women. The National Psoriasis Foundation released guidelines in 2012 for treating psoriasis in pregnant or breastfeeding women. Topical treatments are the first choice of treatment, particularly moisturizers and emollients, such as petroleum jelly. Limited use of low- to moderate-dose topical steroids appears safe, but women should use caution when applying topical steroids to the breasts to avoid passing the medication to the baby while nursing. Read more about using topical treatments during pregnancy or nursing.