Pityriasis Rosea

Question 1

What issue / Tx

(1) Prodromal symptoms are reported in as much as 69% of patients and typically include some variation of the following:
- (a) Malaise, mild fever, headache, sore throat, cough, or mild URI or GI symptoms.
- (b) Begins with a solitary herald patch that appears on the trunk or proximal limbs that precedes secondary eruption by 7-14 days.
- (c) Herald patch: a 2-5 cm round or oval, sharply delimited, pink or salmon-colored lesion on the chest, neck, or back.
- (d) Within 7-14 days, oval lesions similar in appearance to the herald patch, but smaller, appear in crops on the trunk and proximal areas of the extremities.
- (e) Lesions range from 0.5 to 2 cm oval papules and plaques, and have a scaly, slightly raised border (collarette) and resemble ringworm (tinea corporis).
- (f) Lesions are distributed with long axes along cleavage (Langer’s) lines:
- -1) “Christmas tree pattern” on back
- -2) V-shaped pattern on upper chest
- -3) Mild to moderate pruritus is a common complaint. However, in rare cases patients may experience severe pruritus on lesions.
- -4) The rose or fawn color is not as evident in patients with darker skin. Lesions generally resolve spontaneously after ~ 45 days.

Answer 1

Pityriasis Rosea
Symptomatic treatment of pruritus:
1) Non-sedating oral antihistamines (centrizine, loratidine, fexofenadine)
2) Sedating antihistamines if sleep interrupted (benedryl/atarax).
3) Topical corticosteroids commonly used, however, drains AMAL meds due to size or eruption (logistically dumb).
additional info
–5) No treatment or symptomatic treatment is indicated for most patients.
–6) If you’re not actively treating the patient, you’re on the hook for educating the patient why.

Question 2

Complications Pityriasis Rosea

Answer 2

(1) Hyper- or hypopigmentation of resolved lesions may be cosmetic concern; derm consult advised with long-term pigmentary changes post-PR.
(2) PR during pregnancy associated with spontaneous abortion & fetal demise.

Question 3

Pityriasis Rosea is a common, acute, self-limited papulosquamous skin rash that most commonly seen in individuals ____ years old.

Answer 3

10-35

Question 4

Differential Diagnosis Pityriasis Rosea

Answer 4

(1) Tinea Corporis
(2) Tinea Versicolor
(3) Drug eruptions