“…PP is a clinical diagnosis because it lacks specific histopathologic and laboratory findings ( Kroumpouzos and Cohen, 2001 , Roth et al, 2016 ). Its pathophysiology has been elusive, with some authors advocating that PP could develop secondary to scratching in response to pruritus gravidarum (gestational itch; Ingber, 2009 , Roger et al, 1994 ). Associations with obstetric cholestasis or a family history of cholestasis have been reported ( Cicek et al, 2007 ).…”