Presentation
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]
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. [ijpd.in]
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]
Cutaneous examination revealed slightly pigmented well defined circular patches varying in size from 2-10 cms in diameter present on back, buttocks, legs and the volar aspect of left wrist. [ijdvl.com]
Entire Body System
- Asymptomatic
The patient was advised a skin biopsy which was refused by the parents owing to the asymptomatic nature of the lesion. [ijpd.in]
Pityriasis rotunda Priya Batra MD, Wang Cheung MD, Shane A Meehan MD, Miriam Pomeranz MD Dermatology Online Journal 15 (8): 14 Department of Dermatology, New York University Abstract A 42-year-old man presented with asymptomatic, sharply-demarcated, round [escholarship.org]
The lesions are notable for being asymptomatic or mildly symptomatic, sharply defined and typically perfectly circular with no evidence of induration or inflammation [1]. [karger.com]
Nearly perfectly round, slightly hyperkeratotic, hyperpigmented, asymptomatic plaque on the trunk. Classic histology for pityriasis rotunda demonstrating mild hyperkeratosis and a reduced granular layer in the epidermis. [emedicine.medscape.com]
Skin lesions are generally asymptomatic or mildly symptomatic. Pityriasis rotunda plaques are scaly, dry, sharply defined and round with prominent hair follicles but no inflammatory erythema. Scales may be highlighted by scratching the plaques. [ncbi.nlm.nih.gov]
- Weight Loss
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]
Gastrointestinal
- Chronic Diarrhea
[…] 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]
- Abdominal Pain
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]
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
The fourth had mild hypertension. The fifth and sixth patients did not have any associated medical conditions. [emedicine.medscape.com]
Skin
- Dermatitis
[…] planus pemphigoides Other Lichen nitidus Lichen striatus Lichen ruber moniliformis Gianotti–Crosti syndrome Erythema dyschromicum perstans Idiopathic eruptive macular pigmentation Keratosis lichenoides chronica Kraurosis vulvae Lichen sclerosus Lichenoid dermatitis [en.wikipedia.org]
[…] 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 filaggrin 2 in the epidermis of PR lesions, similar to the findings in lesions of atopic dermatitis [actasdermo.org]
Makino et al. reported a decrease in expression of epidermal filaggrin 2, as seen in ichthyosis vulgaris, atopic dermatitis, and psoriasis vulgaris. [ncbi.nlm.nih.gov]
- Follicular Hyperkeratosis
Discrete changes of the surface epithelium with moderate ortho-hyperkeratosis and follicular hyperkeratosis. No formation of a keratohyalin layer. [altmeyers.org]
Workup
Serum
- 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]
Pityriasis Rotunda and Hyperprolactinemia. Actas Dermosifiliogr. 2016 Jul-Aug;107(6):535-7. [PubMed: 27006018] 6. Makino T, Mizawa M, Seki Y, Hayashi M, Shimizu T. Decreased filaggrin-2 expression in the epidermis in a case of pityriasis rotunda. [ncbi.nlm.nih.gov]
Other Pathologies
- Lymphocytic Infiltrate
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, thinned granular layer, pigmented basal layer, and mild perivascular lymphocytic infiltrate are commonly reported, resembling ichthyosis vulgaris.[5] The management of pityriasis rotunda is [ijpd.in]
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]
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]
Follow-up of pityriasis rotunda skin lesions without treatment is the other option because of possible spontaneous resolution. [ncbi.nlm.nih.gov]
Prognosis
The prognosis for pityriasis rotunda is excellent. [emedicine.medscape.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]
Etiology
Discussion The etiology of pityriasis rotunda remains unknown. [ijpd.in]
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; worldwide only a few hundred patients have been described (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]