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Pruritic urticarial papules and plaques of pregnancy is considered the most common pruritic skin condition seen in pregnancy, and its classic presentation and treatment options have been well described. However, the exact etiologic factor of this condition remains obscure. This article presents an unusual case to demonstrate a variation in presentation of this disease as well as a unique course of treatment. The unusual progression of this case may render new insight regarding the etiologic factor of this disease.