I had it with DD starting at 30 weeks. It was complete misery, itching 24/7 and scratching my skin raw. I tried every "remedy" I could find on the internet, plus a steroid cream and a round of oral steroids and ended up with very little relief. I was induced at 37.5 weeks after having an amnio to make sure DD's lungs were mature.
I don't think you would *have* to be induced. PUPPP doesn't cause any harm to the baby, just discomfort to you. The only cure is to deliver, so if you're miserable, that might be an option. Luckily, I haven't gotten it this time around. My OB said that's good, b/c they wouldn't induce before 39 wks due to new ACOG recommendations.