Clinical Presentation The initial presentation of the disease is in most cases marked by the appearance of a herald patch, a well-circumscribed erythematous patch multiple centimeters in diameter with mild central clearing and depression. [pedclerk.bsd.uchicago.edu]

Several less common clinical presentations have been reported. [odermatol.com]

Some data suggest that acyclovir 800 mg orally 5 times a day for 7 days may be helpful in patients who present early and have widespread disease, or present with flu-like symptoms. [merckmanuals.com]

In few days time the rash may spread to other parts of the body presenting as skin redness or inflammation. Rash found on back tend to form a Christmas tree pattern. [indiamart.com]

Atypical presentations of pityriasis rosea: case presentations. J Eur Acad Dermatol Venereol. 2005;19(1):120-126.PubMedGoogle ScholarCrossref 3. Brzezinski P, Sinjab AT. Pityriasis rosea in a 12-month-old infant. [jamanetwork.com]

• Streptococcal Infection

  Guttate psoriasis Usually follows streptococcal infection, small erythematous papules with micaceous white scale, no particular orientation. [3] [16] Antistreptolysin O titers positive. [online.epocrates.com]

  Management of guttate psoriasis and pityriasis rosea in patients with evidence of group A Streptococcal infection. J Drugs Dermatol. 2010 Mar;9(3):241-50. [PubMed: 20232586] 11. Cook B, Crutchfield CE. Pityriasis rosea. [ncbi.nlm.nih.gov]

  Viral infection (herpes 6 and 7) is suspected. [hairscientists.org]

  There may also be a history of preceding streptococcal infection in children with guttate psoriasis. If necessary, histologic examination can usually differentiate these disorders. [dermatologyadvisor.com]

• Military Personnel

  An increased incidence is reported among groups with close physical contact (eg, families, students, and military personnel), though the condition does not appear to be highly contagious. [emedicine.com]

• Chills

  Symptoms Moderate to Severe Pruritus (25-50% of cases) Especially in children Other symptoms present in only 5% of patients Viral prodrome-type constitutional symptoms may occur with mild URI symptoms Headache Malaise Arthralgia s Chills Nervousness Gastrointestinal [fpnotebook.com]

  A review of systems was negative for fever, chills, shortness of breath, headache, abdominal pain, or weight loss. A punch biopsy was obtained for further diagnosis. [escholarship.org]

  In rare cases, particularly in immune-compromised patients like diabetes, hematogenous or metastatic seeding may occur. cellulitis Patients typically report fever, chills, pain, swelling, tenderness, erythema and warmth. [fever.pk]

  A small number (approximately 5%) of patients with pityriasis rosea have mild prodromal symptoms (eg, malaise, fatigue, headache, nausea, anorexia, chills, fever, and arthralgias) that precede the appearance of the herald patch. [emedicine.medscape.com]

• Loss of Appetite

  They may include: Fatigue Fever Headache Sore throat Joint pain Nausea and loss of appetite Irritability When the rash appears, symptoms may include: A herald patch—large, oval, scaly patch that is often on the back, stomach, armpit, or chest. [winchesterhospital.org]

  Sometimes the patch appears without any previous symptoms, but some people have a vague feeling of illness, loss of appetite, fever, headache, and sometimes joint pain a few days before the patch appears. [msdmanuals.com]

  In pregnant women, the eruption may present in a more widespread distribution compared with classic pityriasis rosea and may be associated with systemic symptoms such as fatigue, headache, and loss of appetite. [visualdx.com]

• Arthralgia

  The eruption is usually preceded by a prodrome of sore throat, gastrointestinal disturbance, fever, and arthralgia. A case of PR is diagnosed mainly on clinical grounds. [genome.jp]

  A prodrome of malaise, headache, and sometimes arthralgia precedes the lesions in a minority of patients. Clinical evaluation Diagnosis of pityriasis rosea is based on clinical appearance and distribution. [merckmanuals.com]

  Constitutional symptoms may precede the eruption, including fever, headache, cough, and arthralgia. In a majority of patients, the rash typically resolves within 8 weeks. Recurrence is rare. Adolescents and young adults are most commonly affected. [visualdx.com]

• Eruptions

  Pityriasis rosea • mild, common, self-limited eruption; may be due to human herpesvirus 7 (HHV-7) • suspected infectious etiology due to: occurrence primarily in adolescents and young adults in the spring and fall; recurrence is uncommon • eruption typically [dermweb.com]

  The eruptions are usually generalised, affecting chiefly the trunk, and the course is often self-limiting. (12 Dec 1998) Lexicographical Neighbors of Pityriasis Circinata Other Resources: Words people are searching for today: moteliers, concierges, dicrotic_wave [lexic.us]

  Antipruritic therapy No specific treatment is necessary because the eruption usually remits within 5 weeks and recurrence is rare. Artificial or natural sunlight may hasten resolution. [merckmanuals.com]

  Six days after the eruption of primary lesions, secondary plaques started erupting over abdomen and back. There was no history of similar complaints in the family. [idoj.in]

  […] and may pose a diagnostic challenge.2,3 The morphologic characteristics of the eruption may be papular, vesicular, purpuric or hemorrhagic, or urticarial. [jamanetwork.com]

• Eczema

  It has been given names like "prurigo Besnier," "neurodermitis," "endogenous eczema," "flexural eczema," "infantile eczema," and "prurigo diathésique". [findzebra.com]

  However, does Eczema Free Forever work? Is it really worth the money? Eczema Free Forever discount. [enhance-itn.eu]

  They'll usually be able to confirm whether it's pityriasis rosea, or another skin condition such as eczema, psoriasis or ringworm. If the GP is uncertain, they may refer you to a skin specialist (dermatologist). [nhs.uk]

  Guttate psoriasis, secondary syphilis, cutaneous lupus erythematosus, capillaritis, pityriasis versicolor, nummular eczema, and cutaneous T-cell lymphoma are important to consider in the differential diagnosis of pityriasis rosea. [ncbi.nlm.nih.gov]

• Pruritus

  Except for mild pruritus, pityriasis rosea is asymptomatic. The lesions disappear within two months, often causing postinflammatory hyperpigmentation or hypopigmentation. [amboss.com]

  The aim of treatment is thus mainly to relieve pruritus, not to modify the course of the disease. For children with little or no pruritus and a limited number of lesions, no treatment is generally required. [plasticsurgerykey.com]

  […] evolves over 6-8 weeks - eruption of multiple 1-2 cm oval annular papules with fine "collarette" scaling along the rim of individual lesions • eruption typically evolves over 6-8 weeks - lesions typically located in a "T shirt and shorts" distribution - pruritus [dermweb.com]

  Itching (pruritus) occasionally occurs. Spontaneous remission occurs in 2 to 8 weeks. It is probably caused by an infectious agent, most likely a virus. Causes Pityriasis rosea is believed to be caused by a virus. [mountsinai.org]

  However, some dermatologists use prednisone (0.5-1 mg/kg/day for 7 days) in selected patients with severe pruritus, vesicular lesions, or the potential for significant postinflammatory hyperpigmentation, to suppress both pruritus and the exanthem. [dailyrounds.org]

• Skin Rash

  Rash - pityriasis rosea; Papulosquamous - pityriasis rosea Pityriasis rosea is a common type of skin rash seen in young adults. Pityriasis rosea is a skin disease that produces oval spots (papules) over the trunk. [mountsinai.org]

  The rash starts with a single large patch called a herald patch. After several days, more skin rashes will appear on the chest, back, arms, and legs. [medlineplus.gov]

  Last updated June 12, 2017 Pityriasis Rosea is a benign, skin disorder characterized by the presence of skin rashes. [dovemed.com]

• Papule

  Papules may dominate with little or no scaling in children and pregnant women. [merckmanuals.com]

  Youngson 2004, 2005 pi·tyr·i·a·sis ro·se·a (piti-rīă-sis rō-zēă) A self-limited eruption of macules or papules involving the trunk and, less frequently, extremities, scalp, and face; the lesions are usually oval and follow the crease lines of the skin [medical-dictionary.thefreedictionary.com]

  Pruritic urticarial papules and plaques of pregnancy Discrete pruritic papules and plaques over trunk in primigravida pregnant women in the third trimester, usually predilection for striae; sparing of umbilicus; no herald patch. [15] Clinical diagnosis [online.epocrates.com]

If a case of PR hasn't cleared within 8-10 weeks, I'll usually perform a workup to verify nothing has been overlooked. Currently, there is no treatment available which clears the rash. [web.archive.org]

In such cases, the patient should urgently visit a hospital for further workup and management usually treated with steroids (topical and oral or systemic) analgesics, immunomodulators and immunosuppressive therapy. [fever.pk]

• Hyperprolactinemia

  The patient was a 38-year-old African American woman with a history of hyperprolactinemia on treatment with cabergoline for the previous 7 months. [actasdermo.org]

  Pinos-Leóna L et al (2016) Pityriasis rotunda and hyperprolactinemia. Actas sifiligraphicas 107: 535-537. Rubin MG et al (1986) Pityriasis rotunda: two cases in black americans. J Am Acad Dermatol 14: 74-7. [altmeyers.org]

• Human Herpesvirus 8

  AAT Chuh, PKS Chan and A Lee, The detection of human herpesvirus‐8 DNA in plasma and peripheral blood mononuclear cells in adult patients with pityriasis rosea by polymerase chain reaction, Journal of the European Academy of Dermatology and Venereology [doi.org]

  Detection of human herpesvirus 8 in the skin of patients with pityriasis rosea. Acta Derm Venereol. 2009 Nov. 89(6):604-6. [QxMD MEDLINE Link]. Drago F, Broccolo F, Rebora A. [emedicine.medscape.com]

  Pityriasis rosea is not associated with human herpesvirus 7. Arch Dermatol 1999;135:1070-2. 8. Watanabe T, Sugaya M, Nakamura K, Tamaki K. Human herpesvirus 7 and pityriasis rosea. J Invest Dermatol 1999;113:288-9. [ PUBMED ] 9. [dx.doi.org]

  Pityriasis rosea is not associated with human herpesvirus 7. Arch Dermatol. 1999; 135 :1070–2. [ PubMed ] [ Google Scholar ] 8. Watanabe T, Sugaya M, Nakamura K, Tamaki K. Human herpesvirus 7 and pityriasis rosea. [ncbi.nlm.nih.gov]

• Human Papillomavirus

  Letters To The Editor Pityriasis rosea following human papillomavirus vaccination☆ Giulia Ciccarese1 * Alfredo Rebora1 Aurora Parodi1 1DISSAL, Department of Dermatology, IRCCS A.O.U. [scielo.br]

  Pityriasis rosea following human papillomavirus vaccination. Braz J Infect Dis. 2015 Mar-Apr. 19(2):224-5. [QxMD MEDLINE Link]. Rajpara SN, Ormerod AD, Gallaway L. Adalimumab-induced pityriasis rosea. [emedicine.medscape.com]

  PR-like rashes have also been reported after vaccinations for diphtheria, smallpox, pneumococcal, hepatitis B virus, BCG, and human papillomavirus [ 5, 34 ]. [karger.com]

Treating pityriasis rosea Pityriasis rosea usually gets better without treatment within 12 weeks. Treatment is not needed unless you experience discomfort and itching. [nhs.uk]

In rare cases, the following tests are needed: A blood test to be sure it is not a form of syphilis, which can cause a similar rash A skin biopsy to confirm the diagnosis Treatment If symptoms are mild, you may not need treatment. [mountsinai.org]

Other Treatments Avoid physical activities that can raise your body temperature. [winchesterhospital.org]

Treatment Treatment is unnecessary as the rash resolves on its own within one to three months with minimal associated morbidity. [pedclerk.bsd.uchicago.edu]

[…] cause of the condition is not known, but it is linked to a viral infection Mild cases requires no treatment, although the application of corticosteroids and antihistamines on the rashes can help control itching and redness The disorder has a very good prognosis [dovemed.com]

Outlook (Prognosis) Pityriasis rosea often goes away within 6 to 12 weeks. It usually doesn't come back. When to Contact a Medical Professional Call for an appointment with your provider if you have symptoms of pityriasis rosea. References Habif TP. [mountsinai.org]

Outlook (Prognosis) Pityriasis rosea often goes away within 4 to 8 weeks. It usually doesn't come back. When to Contact a Medical Professional Call for an appointment with your provider if you have symptoms of pityriasis rosea. [ufhealth.org]

AFP 2004 ; 69(1) Links: clinical features management prognosis guttate psoriasis [gpnotebook.co.uk]

"Pityriasis rosea: evidence for and against an infectious etiology." Epidemiology and Infection 132:381-390. Drago F, Broccolo F, Rebora A. 2009. "Pityriasis rosea: an update with a critical appraisal of its possible herpesviral etiology." [pedclerk.bsd.uchicago.edu]

Significantly more parents of children with PR had concerns regarding the etiology, infectivity, relapse, and complications or dangers of the disease. [ncbi.nlm.nih.gov]

Etiology Idiopathic A viral etiology is suspected based on the following: Pityriasis rosea can occur in clusters, affecting many people living in the same community. [amboss.com]

Pityriasis rosea • mild, common, self-limited eruption; may be due to human herpesvirus 7 (HHV-7) • suspected infectious etiology due to: occurrence primarily in adolescents and young adults in the spring and fall; recurrence is uncommon • eruption typically [dermweb.com]

Epidemiology Pityriasis rosea presents most often in patients between the ages of 10 and 35 years of age, though case reports indicate the presence of the disease in patients of all ages. [pedclerk.bsd.uchicago.edu]

Epidemiology References:[1] Epidemiological data refers to the US, unless otherwise specified. [amboss.com]

Previously reported virological and epidemiological results for these rashes are conflicting in many aspects. [ncbi.nlm.nih.gov]

The cause of PR is uncertain but epidemiological (seasonal variation and clustering in communities) and clinical features suggest an infective agent. [genome.jp]

Pathogenesis The pathophysiology of pityriasis rosea is poorly understood. The disease is believed to be viral in origin, given the way in which cases cluster in space and time as well as the low rate of recurrence. [pedclerk.bsd.uchicago.edu]

Sections Continuing Education Activity Introduction Etiology Epidemiology Pathophysiology Histopathology History and Physical Evaluation Treatment / Management Differential Diagnosis Pearls and Other Issues Enhancing Healthcare Team Outcomes Review Questions [pubmed.ncbi.nlm.nih.gov]

It affects people of both genders between 15 and 30 years of age, but it also affects older adults and children.[7] Pathophysiology A lack of natural killer (NK) cell and B-cell activity in pityriasis rosea lesions has been noted, suggesting a predominantly [statpearls.com]

Pathophysiology Pityriasis rosea (PR) has often been considered to be a viral exanthem, a view supported by the condition’s seasonal occurrence, its clinical course, the possibility of epidemic occurrence, the presence of occasional prodromal symptoms [emedicine.com]

Prevention There is no known way to prevent pityriasis rosea. It does not spread from person to person. It is not likely to recur. This rash does not leave permanent marks. However, some people with dark skin may have some skin discoloration. [winchesterhospital.org]

Can it be prevented or avoided? You cannot prevent or avoid this condition. Treatment Treatment cannot cure pityriasis rosea, but medicine can help relieve the itching. Your doctor may suggest antihistamine pills, such as Benadryl. [news.gcu.edu]

100% Emergent - ED Care Needed - Preventable/Avoidable - 0% Emergent - ED Care Needed - Not Preventable/Avoidable - 0% Primary diagnosis of injury 0% Primary diagnosis of mental health problems 0% Primary diagnosis of substance abuse 0% Primary diagnosis [codelay.com]

[…] prognosis; the skin lesions generally resolve with no long-term complications Please find comprehensive information on Pityriasis Rosea regarding definition, distribution, risk factors, causes, signs & symptoms, diagnosis, complications, treatment, prevention [dovemed.com]

Preventing the spread of tinea It is important to remember that tinea is contagious. Suggestions on how to prevent the spread of infection to others include: Treat tinea infections with antifungal cream. [betterhealth.vic.gov.au]