Pityriasis rosea

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Pityriasis rosea
Classification and external resources
An oval rash of Pityriasis Rosea
ICD-10	L42.
ICD-9	696.3
DiseasesDB	24698
MedlinePlus	000871
eMedicine	derm/335 emerg/426 ped/1815
MeSH	D017515

Pityriasis rosea is an acute, self-limiting skin eruption with a distinctive and constant course, with an initial lesion or grouping of lesions ("herald patch") that is followed after 1 or 2 weeks by a generalized, much more spread, secondary rash with a typical distribution and lasting for about 6 weeks.^{[1]:445[2]:208-9}

A medical source describes the condition as non-contagious, [1] however another source says only that it is "non-contagious in the classic sense" [2] and a third does not speak to the question. [3]

PR can affect members of either sex, at any age.

[edit] Symptoms

The symptoms of this condition include:^[3]

Herald lesion of PR (second lesion above the ankle, approximately in the center of the plate) depicted 21 days after initial encounter. The patient had an episode of sore throat, that was treated with a strong antibiotic without success. The lesion appeared approximately one week after the end of the upper respiratory tract infection.

• Large patches of pink or red, flaky, oval-shaped rash on the torso. Due to similarities early in the disease course, the primary differential diagnoses are ringworm, psoriasis and discoid eczema.
• A single, large red "herald" patch may occur 1 to 20 days before smaller, more numerous patches of rash. Occasionally, the "herald" patch may occur in a 'hidden' position (in the armpit, for example) and not be noticed immediately. The "herald" patch may also appear as a cluster of smaller oval spots, and be mistaken for acne. Rarely, it does not become present at all.
• The "herald" patch may be preceded by a sore throat of varying severity.
• The more numerous oval patches generally spread widely across the chest first, following the rib-line. Small, circular patches may appear on the back and neck several days later. It is unusual for lesions to form on the face, but they may appear on the cheeks or at the hairline.
• About one-in-four people with PR suffer from mild to severe symptomatic itching. (Moderate itching due to skin over-dryness is much more common, especially if soap is used to cleanse the affected areas.) The itching is often non-specific, and worsens if scratched. This tends to fade as the rash develops and does not usually last through the entire course of the disease.
• The rash may be accompanied by low-grade headache, fever, nausea and fatigue. Over-the-counter medications can help manage these.

[edit] Treatment

No treatment is usually required. In most patients, the condition lasts only a matter of weeks; in some cases it can last longer (up to six months). A doctor should be consulted, if only to rule out other conditions.^{[citation needed]}

While no scarring has been found to be associated with the rash, itching and scratching should be avoided. Irritants such as soap should be avoided, too; a soap containing moisturizers (such as goat's milk) may be used, however, any generic moisturizer can help to manage over-dryness.^{[citation needed]}

In cases of severe symptomatic itching, topical or oral steroids may be prescribed. (Steroids do provide relief from itching, and improve the appearance of the rash, but they also cause the new skin that forms (after the rash subsides) to take longer to match the surrounding skin color).^{[citation needed]}

Doctor-operated UV therapy, or simple exposure to sunlight, also helps in some cases; serious precautions should be taken to avoid sunburn, though, as this will only exacerbate the problem.^{[citation needed]}

[edit] Epidemiology

The overall prevalence of PR in the United States has been estimated to be 0.13% in men and 0.14% in women. It most commonly occurs in those between the ages of 10 and 35.^{[citation needed]}

[edit] See also

• Skin lesion
• Pityriasis circinata - a localized form of pityriasis rosea that affects the axillae and groin
• Pityriasis - for list of similarly named flaky skin conditions
• Ringworm

[edit] References

[edit] External links

• American Academy of Dermatology - Pityriasis Rosea
• eMedicine.com - Pityriasis Rosea
• WebMD.com - Pityriasis Rosea
• HealthInPlainEnglish - Pityriasis rosea
• DermNet viral/pityriasis-rosea

• http://www.aocd.org/skin/dermatologic_diseases/pityriasis_rosea.html Pityriasis Rosea overview
• Links to pityriasis rosea pictures (Hardin MD/Univ of Iowa)
• Go Ask Alice Health Advice from Columbia University
• American Osteopathic College of Dermatology