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Pityriasis Rotunda

Presentation

Objective: We present a case of pityriasis rotunda in a 44-year-old African-Canadian woman who presented to a community dermatology practice in Toronto. Results: Pityriasis rotunda has been well described in Japan, Italy, and South Africa. [semanticscholar.org]

scaly lesions on his forearms that had been present for several months. [escholarship.org]

It has been associated with systemic diseases and malignant tumors, though many cases present no associated disorders.1 We present a case of intense PR associated with hyperprolactinemia. [actasdermo.org]

We report the case of a 20-year old male Congolese presenting with PR and ichthyosis vulgaris. This rarely described association raises the problem, discussed here, of whether PR belongs to ichthyosis vulgaris. [unboundmedicine.com]

Case Report A 7-year-old female presented to us with a 6-month history of an asymptomatic, dry, scaly circular lesion over the left arm. [journals.lww.com]

Entire Body System

  • Malnutrition

    A genetic predisposition and the presence of infection, malignant conditions, or malnutrition have been suggested. Familial cases have also been described in which an autosomal dominant inheritance appears to be present. [escholarship.org]

    Most authors believe that it is a form of acquired ichthyosis and it has been associated with a variety of conditions including tuberculosis, malnutrition, and malignancy. [ijpd.in]

    Most authors believe that it is a form of acquired ichthyosis and it has been associated with a variety of conditions including tuberculosis, malnutrition, and malignancy.[12] Herein, we report a case of pityriasis rotunda in a 7-year-old otherwise healthy [journals.lww.com]

    […] common between the ages of 20 and 45 years.3 The etiology is unknown, though the majority of authors believe PR to be an acquired form of ichthyosis, a late presentation of congenital ichthyosis, or a cutaneous manifestation of systemic diseases such as malnutrition [actasdermo.org]

    Some authors believe it is a variant of ichthyosis vulgaris because both have similar histologic findings. [13] Some authors believe pityriasis rotunda is caused by malnutrition, but this is not universally accepted. [14] In familial cases, an autosomal [emedicine.medscape.com]

Cardiovascular

  • Heart Disease

    It has also been associated with leprosy, lung and liver diseases, multiple myeloma, chronic myeloid leukemia, heart disease, and diabetes.4,5 Concerning the pathogenesis of PR, Makino et al.6 recently described a reduction or absence of expression of [actasdermo.org]

    […] infections Heart disease Female genital tract anomalies (ovarian cyst and fibroids) Glucose-6-phosphate dehydrogenase deficiency (favism) Chronic diarrhea Scleroderma Sarcoidosis Hormonal disorders such as hyperprolactinemia. [ncbi.nlm.nih.gov]

  • Hypertension

    Her medical history included type II diabetes mellitus, arterial hypertension and dyslipidaemia for approximately 3 years, active smoking and iron deficiency anaemia due to menstrual losses. [x-mol.com]

    The fourth had mild hypertension. The fifth and sixth patients did not have any associated medical conditions. [emedicine.medscape.com]

    Her family history included the maternal grandmother with Alzheimer’s disease, bipolar I disorder and hypertension; mother with breast cancer; and deceased father due to an acute myocardial infarction associated with a thoracic trauma one month after [revistas.unal.edu.co]

Skin

  • Skin Lesion

    Her family history was notable for a sister with similar skin lesions, who is otherwise in good health. [karger.com]

    In some patients, associated skin lesions of ichthyosis vulgaris may be observed. [ncbi.nlm.nih.gov]

  • Hyperpigmentation

    L. publication date 2008 published in Archives of Dermatology Journal Research keywords African Americans Biopsy, Needle Diagnosis, Differential Hyperpigmentation/diagnosis/ethnology/*pathology Immunohistochemistry Nigeria Pityriasis/diagnosis/ethnology [healthpartners.com]

    They had a characteristic circular or arcuate configuration with scaling and varying degrees of hyperpigmentation. Pityriasis rotunda may prove to be a useful cutaneous marker of hepatocellular carcinoma in South African blacks. [meta.org]

    Skin biopsy revealed a hyperkeratosis, a decrease in the granular layer and hyperpigmentation of the basal cell layer compatible with the diagnosis of Pityriasis Rotunda, urinary and hepatic tests were normal. [odermatol.com]

    Histopathological examination revealed hyperpigmentation, hyperkeratosis, parakeratosis, flattening of the str. granulosum with flattening of the papillary body; mild perivascular lymphocytic infiltrate. [altmeyers.org]

    […] between 1 and 100,1 and they can persist for months to years, with exacerbations during the winter.4 Various changes can be seen on histopathology, including hyperkeratosis, flattening of the epidermal crests, a reduction or absence of the granular layer, hyperpigmentation [actasdermo.org]

  • Cutaneous Manifestation

    Most authors believe that it is a form of acquired ichthyosis, a delayed presentation of congenital ichthyosis, or a cutaneous manifestation of systemic disease [1, 7]. [escholarship.org]

    Most authors believe that it is a form of acquired ichthyosis, a delayed presentation of congenital ichthyosis, or a cutaneous manifestation of systemic disease.[1] Researchers have reported an association with lung, liver, stomach, and other types of [journals.lww.com]

    manifestation of systemic diseases such as malnutrition, tuberculosis, cirrhosis, or tumors. [actasdermo.org]

    Pityriasis rosea as a cutaneous manifestation of COVID-19 infection. J Eur Acad Dermatol Venereol. 2020;34(9):e436-7. https://doi.org/ggx33r. 10.Dowling JN. Clinical Features of Disease Due To Legionella Species. In: Katz SM, editor. Legionellosis. [revistas.unal.edu.co]

  • Dry Skin

    Pityriasis rotunda most often develops between the ages of 20 and 45 years, but childhood cases have also been reported.[6] Clinically, typical lesions of pityriasis rotunda are circular, sharply defined patches of dry skin with ichthyosiform scaling, [journals.lww.com]

  • Follicular Plugging

    Skin biopsy showed hyperkeratosis, follicular plugging, areas of diminished or absent granular layer, hyperpigmentation of the basal layer and a sparse perivascular infiltrate of lymphocytes in the dermis (Fig. 2). [x-mol.com]

Workup

Other Pathologies

  • Lymphocytic Infiltrate

    Histopathological examination revealed hyperpigmentation, hyperkeratosis, parakeratosis, flattening of the str. granulosum with flattening of the papillary body; mild perivascular lymphocytic infiltrate. [altmeyers.org]

    Histologically, findings are often subtle, but hyperkeratosis, thinned granular layer, pigmented basal layer, and mild perivascular lymphocytic infiltrate are commonly reported, resembling ichthyosis vulgaris.[5] The management of pityriasis rotunda is [journals.lww.com]

    Histopathology revealed hyperkeratosis, parakeratosis, a reduction in the granular layer, increased pigmentation of the basal keratinocytes, loss of the crest pattern, and a mild superficial perivascular lymphocytic infiltrate (Fig. 1). [actasdermo.org]

    Histologically, findings are often subtle, but hyperkeratosis, a thinned granular layer, pigmented basal layer, and mild perivascular lymphocytic infiltrate are commonly reported [8]. [karger.com]

Biopsy

  • Hepatocellular Carcinoma

    Discover the latest research on Hepatocellular Carcinoma here. [meta.org]

    Pityriasis rotunda is a disorder of keratisation of the skin that manifests as a perfectly circular, scaly patches on the torso and proximal portions of the extremities.[1] It may be associated with diseases like hepatocellular carcinoma in racially predisposed [wikiwand.com]

    carcinoma in racially predisposed groups.[3] See also[edit] Skin lesion List of cutaneous conditions References[edit] ^ a b James, William; Berger, Timothy; Elston, Dirk (2005). [en.wikipedia.org]

    Hepatocellular carcinoma and cirrhosis were excluded. The patient was not able to establish the source of possible viral transmission. [x-mol.com]

Treatment

There is no specific treatment for pityriasis rotunda. Lesions usually improve or resolve with treatment of the underlying internal disease or malignancy. [dermnetnz.org]

She reported no associated symptoms or previous treatment. [actasdermo.org]

Treatment of the disease can be challenging, and several different pharmacological treatments have been tried with limited success. [karger.com]

There is no specific treatment for pityriasis rotunda. [rarediseases.info.nih.gov]

Prognosis

They rarely itch, slowly enlarge, and coalesce and may be hypo- or hyper-pigmented.[234] Onset in childhood has been reported to have a better prognosis, with remission in later childhood in almost 50%.[6] Lesions are commonly seen on the buttocks, thighs [journals.lww.com]

They rarely itch, slowly enlarge, and coalesce and may be hypo- or hyper-pigmented.[2],[3],[4] Onset in childhood has been reported to have a better prognosis, with remission in later childhood in almost 50%.[6] Lesions are commonly seen on the buttocks [ijpd.in]

The prognosis for pityriasis rotunda is excellent. [emedicine.medscape.com]

Etiology

Discussion The etiology of pityriasis rotunda remains unknown. [ijpd.in]

Figure 1: Single well-defined circular, scaly macule over the arm Discussion The etiology of pityriasis rotunda remains unknown. [journals.lww.com]

The etiology of pityriasis rotunda remains unknown, and the diagnosis is usually based on clinical examination. Importantly, the condition is often associated with underlying malignancies and chronic diseases or infections. [karger.com]

Pityriasis rotunda, not commonly encountered in some regions of the world, is not always easy to diagnose.[1][2][3] Etiology The etiology of pityriasis rotunda is not established. [ncbi.nlm.nih.gov]

Epidemiology

Clinical and epidemiological study and follow-up on 47 cases observed in north Sardinia (1981-1995). Ena P., Chiarolini F., Gallus D., Spano G., Masotti A., Leigheb G. Università degli Studi - Sassari, Istituto di Clinica Dermatologica Background. [minervamedica.it]

Occurrence/Epidemiology This section has been translated automatically. w:m=3:1; several hundred patients have been described worldwide (Al-Refu et al. 2018). Etiopathogenesis This section has been translated automatically. [altmeyers.org]

However, researchers have not eliminated the idea that the association of some of these conditions associated with pityriasis rotunda, especially favism, could be due to chance.[4][5][6][7] Epidemiology Pityriasis rotunda affects both genders equally, [ncbi.nlm.nih.gov]

Pathophysiology

Pathophysiology The pathophysiology of pityriasis rotunda is still not completely understood. It may be a variant of ichthyosis vulgaris. [emedicine.medscape.com]

Pathophysiology Hashimoto et al. described a diminished expression of loricrin and filaggrin in pityriasis rotunda lesions. According to Yoneda et al., a complete absence of the profilaggrin-N terminus domain is observed in the lesional skin. [ncbi.nlm.nih.gov]

Prevention

/kg/day for 5 days, maximum 500 mg/day Acyclovir 400mg per os every 4 hours for 5 days 800mg per os s 5 times per day Phototherapy UVB 5 times/week Special cases Children with severe pruritus Methylprednisolone 16mg/day Pregnant women: acyclovir may prevent [revistas.unal.edu.co]

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