2004 Jan 1. [41]. 2009 Aug. 21(4):481-5. J Invest Dermatol. Kempf W, Adams V, Kleinhans M, Burg G, Panizzon RG, Campadelli-Fiume G, et al. Drago F, Rebora A. Do not send off a serologic test for syphilis without ensuring that the results will be seen and acted on. However, unlike the scale in classic tinea corporis, the scale in pityriasis rosea does not extend to the border of the lesion. Other eruptions that can resemble pityriasis rosea include guttate psoriasis, viral exanthems (particularly some cases of Gianotti–Crosti syndrome), secondary syphilis (Fig. 20(6):667-71. [Medline]. Management of guttate psoriasis and pityriasis rosea in patients with evidence of group A Streptococcal infection. Guarneri C, Polimeni G, Nunnari G. Pityriasis rosea during etanercept therapy. Occasionally, pityriasis rosea spreads to involve much of the skin surface, including the face and distal extremities. 1-6. Stulberg DL, Wolfrey J. Pityriasis rosea. The eruption is typically pruritic. An inverse pityriasis rosea may be seen, in which the generalized rash spreads to areas it usually does not affect, such as the face, hands, and feet. 2007 Oct. 21(9):1294-6. [Medline]. J Eur Acad Dermatol Venereol. The herald patch often is misdiagnosed as eczema. 2016 Apr 21. The long axes of the patches often run parallel to the skin lines over the thorax and back, to create a ‘Christmas-tree’ pattern.

1992 Oct. 50(4):276-80. In 50 to 90% of patients, pityriasis rosea starts with a primary lesion (herald patch), which is an erythematous, scaly, oval patch a few centimeters in diameter.

These are effective only in the most severe inflammatory varieties of this syndrome. Treatment is primarily symptomatic, including topical corticosteroids and oral antihistamines. Int J Trichology. [Medline]. [52] ).

https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTEwNzUzMi1jbGluaWNhbA==. Individuals with dark skin are particularly likely to experience postinflammatory hyperpigmentation that may take a few months to heal. The eruption is symmetric and most commonly involves the thorax, back, abdomen, and adjoining areas of the neck and extremities; lesions are not usually observed on the face, hands, and feet. J Eur Acad Dermatol Venereol. Similar “pityriasiform” skin eruptions occur in other skin diseases, but these are less common than pityriasis rosea. Biopsy is indicated only when the diagnosis is uncertain and the patient has failed to respond to treatment, Henry W. Lim, in Goldman's Cecil Medicine (Twenty Fourth Edition), 2012. [Medline]. 3.40), and drug reactions (gold salts, bismuth, clonidine, penicillamine, isotretinoin, metronidazole, ACE inhibitors). [Full Text]. 2(7722):493. Several investigators have detected DNA sequences for human herpesvirus 6 and human herpesvirus 7 in patients with pityriasis rosea.

The spots look almost identical on both sides of the body. Classically, it begins with a single red and slightly scaly area known as a "herald patch". Rasi A, Tajziehchi L, Savabi-Nasab S. Oral erythromycin is ineffective in the treatment of pityriasis rosea. [Medline].

Drago F, Ciccarese G, Rebora A, Broccolo F, Parodi A. Pityriasis Rosea: A Comprehensive Classification. Ganguly S. A Randomized, Double-blind, Placebo-Controlled Study of Efficacy of Oral Acyclovir in the Treatment of Pityriasis Rosea. 2001 Dec. 6(3):197-202. Yüksel M. Pityriasis Rosea Recurrence is Much Higher than Previously Known: A Prospective Study.

Canpolat Kirac B, Adisen E, Bozdayi G, Yucel A, Fidan I, Aksakal N, et al. [Medline]. Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, New York Academy of Medicine, Royal College of Physicians of Edinburgh, Sigma XiDisclosure: Nothing to disclose. [Medline].

Ultraviolet B phototherapy results in clinical improvement in some individuals. This initial lesion enlarges over a few days to become a patch with a collarette of fine scale just inside the well-demarcated border. Diagnosis is usually made on clinical grounds. 35(3):300-4. 2009 Jul. [Medline]. Arch Dermatol. Blaschkoid pityriasis rosea. [Medline]. CD005068. [Medline]. Copyright © 2020 Elsevier B.V. or its licensors or contributors. [44] Individual patches are 3-6 cm in diameter, exhibiting the characteristic central clearing and collarette of scale with surrounding erythema. Richard Lichenstein, MD is a member of the following medical societies: American Medical Association, American Academy of PediatricsDisclosure: Nothing to disclose. Numerous drugs have been implicated in a severe prolonged exanthem that resembles PR. Approximately 20% of patients present with atypical or variant forms of pityriasis rosea. 58(5 Suppl 1):S78-83. J Low Genit Tract Dis.

[Medline]. Please confirm that you would like to log out of Medscape. Bernard A. Cohen, in Pediatric Dermatology (Fourth Edition), 2013.

J Am Acad Dermatol. Rebora A, Drago F, Broccolo F. Pityriasis rosea and herpesviruses: facts and controversies. Osawa A, Haruna K, Okumura K, Taneda K, Mizuno Y, Suga Y. Pityriasis rosea showing unilateral localization. Studies have associated PR with active human herpesvirus type 6 and type 7 and have suggested that PR represents a viral reactivation phenomenon. [Medline]. Finnish Medical Society Duodecim. [Medline]. 2006 Jan. 54(1):82-5. [Medline]. Central clearing gives rise to an annular lesion. Singh M, Pawar M, Chuh A, Zawar V. Pityriasis rosea: elucidation of environmental factors in modulated autoagressive etiology and dengue virus infection. Ang CC, Tay YK. [48] Erythema multiforme–like plaques may be evident. Curr Opin Pediatr. Drago F, Broccolo F, Javor S, Drago F, Rebora A, Parodi A. Pityriasis rosea is a self-limited condition that usually resolves in 6 to 12 weeks. Amer A, Fischer H, Li X. These oval 0.5- to 2-cm lesions have their long axis oriented along skin lines, and when present on the trunk, result in a “Christmas tree” pattern on the back (Fig. 2007 May. 2015 Jan-Feb. 81(1):56. 34(2):269-70. Here we review clinical aspects of pityriasis rosea, mycosis fungoides, stage 2 syphilis, exanthematic Kaposi sarcoma, exanthematic psoriasis, Leser-Trelat syndrome, and other primary skin diseases with a Christmas tree pattern. The inverse form of pityriasis rosea involves the intertriginous areas, face, arms, or legs. Indian J Dermatol. Browning JC. 2019 Jun 1. Dermoscopy evaluation using a triple-light source may be useful. 2013 Jan 22. The “herald patch” may not be seen in 20% to 30% of cases, and there are many variations from the classic presentation described. [Medline]. Bhalla N, Tambe S, Zawar V, Joshi R, Jerajani H. Localized purpuric lesions in a case of classical pityriasis rosea. This 3–5 cm diameter, isolated, oval, scaly, pink patch, may appear anywhere on the body surface, although it occurs most commonly on the trunk and thighs. Young children, particularly African-Americans, may have an “inverse” type of pityriasis rosea, with most lesions distributed on the distal extremities, face, neck, and intertriginous regions. The primary lesions may be papules, vesicles, pustules, or urticarial or purpuric plaques. 230(1):23-6. This produces the classic “Christmas tree” pattern on the trunk (see the image below). [Medline]. Performing a KOH preparation can differentiate these two conditions. Herald patch. Singh V, Sharma M, Narang T, Madan M. Vesicular palmoplantar pityriasis rosea. Occasionally, pityriasis rosea spreads to involve much of the skin surface, including the face and distal extremities. Dirk M Elston, MD is a member of the following medical societies: American Academy of DermatologyDisclosure: Nothing to disclose. [Medline]. This produces the classic “Christmas tree” pattern on the trunk (see the image below). The efficacy of macrolides and acyclovir in pityriasis rosea. Pityriasis rosea is not associated with human herpesvirus 7. [Medline]. 3.39a). J Am Acad Dermatol. The cause is not known, and a possible association with human herpesvirus types 6 and 7 has been reported. Copyright © 2011 Elsevier Inc. All rights reserved. Zawar V, Kumar R. Multiple recurrences of pityriasis rosea of Vidal: a novel presentation.

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