28559815 Visualization

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