Rash in Pregnancy: Causes and Differential Diagnosis
Skin rashes during pregnancy can result from hormonal changes, immune shifts, or pre-existing conditions. Some rashes are benign, while others may indicate underlying systemic concerns.
Common Causes of Pregnancy-Related Rashes
1. Polymorphic Eruption of Pregnancy (PEP) / Pruritic Urticarial Papules and Plaques of Pregnancy (PUPPP)
- Appearance: Red, itchy papules & plaques, often starting in stretch marks
- Common In: Third trimester, especially first pregnancies
- Cause: Skin stretching & immune response
2. Atopic Eruption of Pregnancy (AEP)
- Appearance: Eczema-like patches, dryness, and itching
- Common In: Any trimester, worsens with pre-existing eczema
- Cause: Immune hypersensitivity
3. Intrahepatic Cholestasis of Pregnancy (ICP)
- Appearance: No rash initially, but intense itching (especially palms & soles)
- Common In: Third trimester
- Cause: Liver dysfunction, bile acid buildup (requires urgent medical attention)
4. Pemphigoid Gestationis
- Appearance: Blistering rash, starting around the belly button
- Common In: Second & third trimester
- Cause: Autoimmune reaction affecting the skin
5. Prurigo of Pregnancy
- Appearance: Small, itchy nodules on arms & legs
- Common In: Any trimester
- Cause: Immune response to pregnancy-related changes
6. Fungal or Bacterial Infections
- Appearance: Red, scaly patches (fungal) or pustular lesions (bacterial)
- Cause: Increased skin moisture & immune changes
When to Seek Medical Attention?
🚨 Severe itching without a visible rash – Could indicate cholestasis
🚨 Blistering or painful rash – Possible autoimmune reaction
🚨 Fever, pus, or spreading redness – May indicate infection
At SKINFUDGE, Dr. Burhan Hussein, MD, specializes in diagnosing and treating pregnancy-related skin conditions safely. Book your consultation today!
Citations
- Ambros-Rudolph, C. M., Müllegger, R. R., Vaughan-Jones, S. A., Kerl, H., & Black, M. M. (2006). The specific dermatoses of pregnancy revisited and reclassified: Results of a retrospective two-center study on 505 pregnant patients. Journal of the American Academy of Dermatology, 54(3), 395-404. https://doi.org/10.1016/j.jaad.2005.10.010
- Rodrigues, C., & Pineiro-Maceira, J. (2017). Skin diseases unique to pregnancy. Anais Brasileiros de Dermatologia, 92(1), 34-44. https://doi.org/10.1590/abd1806-4841.20175037