fluticasone and Urticaria

Pruritic urticarial papules and plaques of pregnancy (PUPPP) is among the most common dermatoses of pregnancy. Most reports of the effective treatment of PUPPP involve high potency topical corticosteroids or oral steroids. Many authorities have noted cases of PUPPP whose resolution followed parturition. A few have noted that PUPPP can arise and resolve the third trimester. A 36-year-old prima gravida at 38 weeks of gestation presented with a 2-week history of a pruritic papular abdominal eruption. She used fluticasone propionate 0.05 percent lotion twice a day. One week after starting this medication, the pruritus had resolved and the erythema/urticaria had abated; the pigmentary alteration had improved, but still remained. The PUPPP did not return after parturition. PUPPP can abate entirely during pregnancy. Fluticasone propionate 0.05 percent lotion, a class 5 (low-medium potency) corticosteroid, has a benign side effect profile and should be considered for the treatment of PUPPP during pregnancy.

Topics: Administration, Cutaneous; Adult; Androstadienes; Erythema; Female; Fluticasone; Humans; Melanosis; Pregnancy; Pregnancy Complications; Pruritus; Skin Diseases, Papulosquamous; Urticaria

Topics: Child, Preschool; Dermatologic Agents; Female; Fluticasone; Humans; Symptom Flare Up; Tic Disorders; Tics; Urticaria

Urticarial vasculitis is a relatively rare diagnosis in a patient presenting with urticaria. The process is classically described as a generalized eruption, painful more so than pruritic, lasting longer than 24 hours. Two forms of urticarial vasculitis have been described: ahypocomplementemic form more commonly associated with systemic disease, and a normocomplementemic form that is generally limited to the skin. We report on a uniquely distributed vasculitic eruption restricted mainly to the anterior belt line area in a patient presenting with urticaria and intense pruritus. Urticarial vasculitis as a unique entity is reviewed along with its clinical and histopathologic presentation and the pharmacologic agents used for treatment.

Topics: Adult; Androstadienes; Anti-Allergic Agents; Anti-Inflammatory Agents; Colchicine; Drug Therapy, Combination; Fluticasone; Humans; Male; Neurodermatitis; Prednisone; Pruritus; Urticaria; Vasculitis, Leukocytoclastic, Cutaneous