The lesions were basically observed to be of two types. A placque like lesion that appeared to be very subtle and the more prominent, large, edematous dark lesion. The patient had a full hematologic work up and liver profile. There was no evidence of liver enzymopathy, coagulopathy or thrombocytopenia. A clinical diagnosis of the PUPPP (Pruritic Urticarial Papules and Placques of Pregnancy) syndrome was made. She was treated with triamcinolone cream 0.1%. One week later the dark colored lesions had almost disappeared and itching was minimal.