Pruritic urticarial papules and plaques of pregnancy in twin and triplet pregnancies.

BACKGROUND: Pruritic urticarial papules and plaques of pregnancy (PUPPP) is a common dermatosis of unknown aetiology. Multiple pregnancies occur frequently in most reported series of PUPPP and increased abdominal distension has been considered a factor in its causation.

OBJECTIVES: To determine the frequency of PUPPP in twin and triplet pregnancies.

METHODS: A retrospective review of all the records of patients delivered of twin or triplet pregnancies over an 18-month period at a busy general maternity hospital.

RESULTS: One hundred and thirty-eight women delivered twins, four of whom developed PUPPP (2.9%). Fourteen women delivered triplet pregnancies, two of whom developed PUPPP (14%). Four of these six multiple pregnancies were conceived by in vitro fertilization.

CONCLUSIONS: The reported rate of PUPPP in single pregnancies is 1 in 200 (0.5%). Our findings suggest that multiple pregnancies are at a higher risk of developing this cutaneous eruption with 2.9% of twin and 14% of triplet pregnancies affected in our study.