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+A 34-year-old woman, 1 week postpartum, presented to our dermatology clinic with an intensely pruritic generalized rash.
+Two days after delivery of her child, the patient developed an itchy rash on the abdomen.
+On discharge, she was instructed to follow up with the dermatology department if the rash did not resolve.
+After leaving the hospital, she reported that the eruption had progressively spread to the buttocks and legs and the itching seemed to be worse.
+The patient's prenatal course was uneventful.
+She gained 13 kg during pregnancy, with a prepregnancy weight of 72 kg.
+A healthy male neonate was delivered by caesarean section at 38 weeks' gestation without complication.
+The patient's medical history was unremarkable.
+She was currently not taking any medications, and she reported no known drug allergies.
+On physical examination, the patient was afebrile and her blood pressure was normal.
+Examination of the skin revealed erythematous papules and urticarial plaques involving the abdominal striae with periumbilical sparing.
+Similar lesions were noted on the legs and buttocks (Fig.1a).
+The face, palms, and soles were uninvolved.
+No vesicles or pustules were noted.
+Based on the characteristic clinical presentation and disease course, she was diagnosed with PUPPP.
+She was informed of the safety profile and potential benefits of medications but remained reluctant to use medications during lactation, despite her severe symptoms.
+AWB injection was then considered for her treatment.
+Venous blood of 10 mL was drawn from the patient, followed by intramuscular injection of 5 mL of the blood on each side of her buttock.
+Seven days later, both subjective and objective improvements of symptoms were noticed and she received 1 more session of AWB injection (Fig.1b).
+On follow-up after 12 days, all subjective symptoms had improved, leaving only postinflammatory hyperpigmentation (Fig.1c).
+No complications such as infection, abscess formation, or hematoma were observed at the injection site.