Simone is a 29-year-old primigravida who presents with two weeks of an itchy rash. 

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<p>Simone is a 29-year-old primigravida who presents with two weeks of an itchy rash.</p><p>She is currently 36 weeks’ gestation in an otherwise uncomplicated twin pregnancy.</p><p>The rash began as a few red patches within striae on her lower abdomen but has extended to involve most of the abdomen (sparing the periumbilical region), thighs and upper arms.</p><p>With this progression, the rash has become increasingly itchy.</p><p>Simone is usually very well, with no previous skin concerns, no known allergies or atopy.</p><p>Blood tests, including FBC, EUC, LFTs, bile acids and coagulation profile, are normal.</p><p>She takes no regular medications and has not been applying anything to the area.</p><p>Examination is unremarkable apart from the rash (pictured).</p>

Dr Kate Kelso is a GP and medical editor at Australian Doctor.