Pityriasis rosea

Pityriasis rosea (lot. Pityriasis rosea) – an acute, self-limiting, exanthematic skin disease that manifests as itchy, somewhat inflammatory, scaly rashes, usually on the torso, chest, and upper limbs. This disease mostly affects older children and young adults (10-35 years old), somewhat more often women than men. In some cases, the rash may be preceded by a headache, sore throat, runny nose, general malaise, or fever, but the course of the disease is usually asymptomatic. It is important to mention that pityriasis rosea is a non-contagious disease and does not pose a health risk.

What causes Pityriasis rosea?

• Viral respiratory tract infections
• Reactivation of human herpesvirus type 7 (HHV-7)
• Weakened immune system
• Quite often the cause remains unknown

Clinical symptoms

• In 50-90 percent of cases, the disease begins with a “maternal” plate/spot, which is also called a medallion in the literature. A “mother” plaque is oval or round, pink or slightly orange in color (salmon pink), usually scaly, 2-5 cm in diameter, usually localized in the chest, neck or back.
• Centrifugal flaking soon appears, disappearing from the center to the periphery. White, thin scales resembling cigarette paper are characteristic.
• After a few days and sometimes weeks, multiple small erythematous plaques appear, which are usually arranged along the skin lines (“Christmas tree” arrangement along Blaschko’s lines).
• The face in adults usually remains intact.
• Accompanying symptoms: itching, which is mild at first, but can be very strong.
• People with dry skin or atopic dermatitis are more often and more severely affected.
• In children, this disease manifests itself in atypical localizations: in the area of the hairy part of the head and on the face; less often – on the face and lower limbs or in the armpits and groin areas.

Diagnostics

Diagnosis is based on history and clinical presentation. In rare cases, when the rash is not completely typical, it is necessary to investigate for other skin diseases. Sometimes the “native” plaque can resemble the rash of a fungal skin infection. In such cases, a microscopic examination of the skin for the fungus is performed.

Blood tests for this disease are not routinely performed.

Treatment

• In most cases, the rash disappears on its own within 4-8 weeks.
• Gentle skin care, emollients 2-3 times a day, avoiding irritating factors are recommended.
• In case of intense itching, topical glucocorticosteroids, antihistamines or anti-itch creams containing menthol are prescribed.
• Since itching can be aggravated by sweating and friction, it is recommended to avoid hot showers, intense sweating, skin scrubs, and soap.
• UVB 311 nm phototherapy procedures.
• In severe cases, when the disease progresses, oral glucocorticosteroids or antiviral systemic treatment are used.

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