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Pityriasis rosea is a relatively common skin disorder. In its typical form it is easily recognizable; however, atypical forms can pose diagnostic problems. We report a 44-year-old woman with an acute onset of a localized eruption on her left breast. The morphology of the rash and the time course were typical of pityriasis rosea. Localized pityriasis rosea is an unusual variant, which has been described previously.
Pityriasis rosea is a common, acute exanthem of uncertain etiology. Viral and bacterial causes have been sought, but convincing answers have not yet been found. Pityriasis rosea typically affects children and young adults. It is characterized by an initial herald patch, followed by the development of a diffuse papulosquamous rash. The herald patch often is misdiagnosed as eczema. Pityriasis rosea is difficult to identify until the appearance of characteristic smaller secondary lesions that follow Langer's lines (cleavage lines). Several medications can cause a rash similar to pityriasis rosea, and several diseases, including secondary syphilis, are included in the differential diagnosis. One small controlled trial reported faster clearing of the exanthem with the use of erythromycin, but the mechanism of effect is unknown. Resolution of the rash may be hastened by ultraviolet light therapy but not without the risk of hyperpigmentation. Topical or systemic steroids and antihistamines often are used to relieve itching.
Pityriasis rosea is a frequently occurring skin disease of unknown aetiology. Ten clinical forms of this disease are known, with predominance of the macular type. We observed a healthy 24-year-old patient with the very rare vesicular variant of pityriasis rosea, which has to be differentiated from vesicular virus and drug-induced eruptions.
Pityriasis rosea (PR) is a seasonal papulosquamous disorder that can be easily confused with a wide variety of similar appearing cutaneous disorders. This is particularly evident in its atypical papular form. We present a case report of atypical papular PR, along with a discussion of clinical presentation, histologic criteria, proposed etiology, and treatment options. Papular PR is atypical, presenting in a minority of patients, and may pose a diagnostic challenge. Being familiar with these atypical characteristics will facilitate accurate and timely diagnosis.
Pityriasis rosea (PR) is an acute exanthematous inflammatory skin disease in which many epidemiological studies suggest a viral infection in its pathogenesis. Several viruses such as picornaviruses, parvoviruses and herpes viruses were accused as causative agents in PR. Human herpes virus-6 (HHV-6) and HHV-7 are newly discovered members of herpesviridae family. Several diseases including roseola infantum and PR have been linked with HHV-6 and HHV-7 in dermatology. We aimed to investigate the role of HHV-6 and HHV-7 in the pathogenesis of PR. Blood samples from 35 patients with acute PR and 30 healthy volunteers were examined to obtain titres for HHV-6 and HHV-7 antibodies. Anti-HHV-6 and -HHV-7 immunoglobulin (Ig) G antibodies were detected by IFA. The high titres of anti-HHV-6 IgG were determined in four patients and anti-HHV-7 IgG in only two of four patients. In our study, we haven't found any significant relationship between HHV-6, HHV-7 and PR. Our results were supported with the data of several previous studies.
Pityriasis rosea is a common, self-limited, scaling disorder of unknown etiology, seen predominantly in young adults. The lesions, typically found on the trunk and proximal extremities, are ovoid, salmon-colored and symmetric. A "herald patch" appears in 70 percent of cases. Variants appear frequently. Papular, urticarial, vesicular or hemorrhagic lesions may be seen. Management with antipruritic lotions, emollients or antihistamines may be necessary to relieve itching.
OBJECTIVES: Pityriasis rosea (PR) is a common skin disorder in children. Its cause is unknown. A recent publication reported a 73% cure rate in patients with PR after treatment with erythromycin. To duplicate this result using a drug with fewer adverse effects and greater biological half-life, we set out to study the effect of azithromycin on PR. Azithromycin is an azalide antibiotic with a spectrum of antimicrobial activity very similar to that of erythromycin. DESIGN: We randomly assigned 49 children with PR to receive either azithromycin (12 mg/kg per day, up to a maximum of 500 mg/day) for 5 days or a similar-appearing placebo. Study physicians were blinded to patients' treatment type. Two pediatricians had to agree on the diagnosis of PR before patients could be enrolled. Subjects were seen at follow-up visits 1, 2, and 4 weeks after starting treatment. OUTCOME MEASURES: We measured the appearance of new lesions and resolution of lesions. RESULTS: Rates of cure and of partial resolution were similar in the azithromycin and placebo groups. CONCLUSION: Azithromycin does not cure PR.
BACKGROUND: Pityriasis rosea (PR) is a common papulosquamous skin disorder that is suspected to have an infectious aetiology. OBJECTIVES: We aimed to study the role of human herpesvirus (HHV)-7 and HHV-6 in the pathogenesis of PR. METHODS: We performed seroepidemiological studies (indirect immunofluorescence test) and polymerase chain reaction (PCR) analysis for HHV-6 and HHV-7 in patients with PR. Seventy-two serum samples and 37 samples of peripheral blood mononuclear cells (PBMC) from 44 patients with PR were obtained. Twenty-five patients with other skin disorders such as drug eruption, urticaria or herpes zoster were studied as controls in the PCR analysis. RESULTS: HHV-7 DNA was detected in 13 of 30 (43%) samples of PBMC of the patients with PR and 14 of 25 (56%) samples of PBMC of controls. HHV-6 DNA was detected in six of 29 (21%) patients with PR and nine of 23 (39%) controls. Thus there was no difference in the prevalence of HHV-6 or HHV-7 in PBMC between patients with PR and those with other skin disorders. In the seroepidemiological study, two cases of at least a fourfold rise in titre and five cases of a fourfold decrease in titre to HHV-7 antibody, and two cases of a fourfold rise in titre and two cases of a fourfold decrease in titre to HHV-6 antibody, were observed in 24 patients with PR. This seroepidemiological study revealed antibody responses consistent with active infection in several PR patients, but the greater proportion of the patients had no definite increase in the antibody titres. CONCLUSIONS: We conclude that HHV-7 and HHV-6 may play a part in some patients with PR, but that other causative agents may exist. Further analyses are needed to determine the causative agents of PR.
Pityriasis rosea (Gibert) is an acute self limited disease with clinically characteristic skin eruptions. In about 20% of cases complications with an atypic clinical picture and a prolonged course are found. Histopathology and ultrastructure of the lesions are not characteristic. The etiology is unknown.
A pityriasis rosea-like eruption developed in two acne patients receiving isotretinoin and gradually resolved once the dosage was reduced. Histologically the lesions, which were characterized by psoriasiform hyperplasia, bore no resemblance to pityriasis rosea. We believe the eruptions were a side effect of isotretinoin therapy.
Pityriasis rosea presents in the Sudan with the same picture as it does in other countries of Africa. The seasonal incidence is highest in the cold, dry months. The erythematous or rosea picture seen in whites is never encountered in blacks. The term pityriasis rosea may not be descriptive of the disease as it presents in black and brown skins.
Pityriasis rosea is a common self-limited dermatologic disorder. It appears to be a nonspecific cutaneous reaction pattern with a large number of causes. Current evidence indicates that a cell-mediated immune mechanism may be important in its pathogenesis.
Pityriasis rosea is a common skin disorder seen in dermatological practices. A one year prospective study on pityriasis rosea was carried out in Middle Road Hospital, Singapore. A total of 214 patients were studied. The incidence rates by age, sex and month were analysed. The peak incidence was in the 20-24 age group. There was a male predominance. More patients with pityriasis rosea were seen in the months of March, April and November. The clinical features in our patients concur with other studies. Blood for VDRL was done on 170 patients. Two had a biological false positive test. Total white counts were normal in 97.9% of specimens done. The rash lasted from 1 to 8 weeks in 84.4% of the patients with most patients suffering from the rash for 5 weeks.
Six cases of pityriasis rosea with atypical morphology and distribution of the eruption are reported. The eruption did not show a typical 'Christmas-tree' arrangement, confined to the trunk and proximal parts of the extremities. However, the histology of the eruption revealed dyskeratotic cells in the epidermis and extravasated erythrocytes in the dermis, which were recently reported as rather characteristic findings of this disease. Prodromal symptoms, course and response to therapy were compatible with pityriasis rosea. Histological examination is important and helpful for the diagnosis of atypical cases.
Pityriasis rosea is a common, acute, self-limited papulosquamous eruption of possible viral aetiology. The aim of this study was to describe the profile of pityriasis rosea seen at a referral skin centre in Singapore. A retrospective chart review was conducted of all the patients with a diagnosis of pityriasis rosea seen during 1996. There were 368 patients; their ages ranged from 9 months to 82 years with a peak in the 20 to 29 years age group. There were slightly more males (1.2:1). The clinic incidence was 6.5 per 1000 cases. No ethnic predilection was noted and cases were seen evenly throughout the year. About a quarter of the patients gave a history of a viral infection shortly before or during the occurrence of the rash. Most cases had a typical truncal distribution. The herald patch was observed in 63 patients (17%). Inverse distribution involving mainly the extremities were seen in 22 cases (6%) and eczematised lesions were noted in 20 cases (5.4%). The two main differential diagnoses considered were tinea infection and secondary syphilis. A fungal scrape and a rapid plasma reagin test were done in 58 and 59 patients, respectively, and the results were negative. Treatment was symptomatic and consisted of topical steroids and antihistamines. Thirty patients (8%) were given oral prednisolone for extensive eruptions. The pattern of pityriasis rosea in Singapore is similar to that reported in other countries except for a male predominance and absence of monthly variation. A lower incidence and an older group of patients were also seen in our series as compared to African patients.
BACKGROUND: Pityriasis rosea is a common self-limiting disease. UV light has been mentioned as helpful, but only a few studies substantiate this possibility. OBJECTIVE: Our purpose was to evaluate the clinical efficacy of UVB phototherapy in pityriasis rosea and the course of the disease after treatment. METHODS: Seventeen patients with extensive pityriasis rosea were treated with unilateral UVB phototherapy in a bilateral comparison study. One joule of UVA was used as a "placebo" on the untreated side. The treatments were given five times per week for 2 weeks. The rate of clearing was monitored by estimation of the severity score. RESULTS: Ten daily erythemogenic exposures of UVB resulted in substantially decreased severity of disease, greater than that on the untreated side in 15 of 17 patients. The overall reduction of severity score showed a significant difference after the third treatment; the UVB irradiation was superior. However, during the follow-up period the two sides were indistinguishable in regard to severity score (p = 0.6784). No significant difference in pruritus was noted between the two sides (p > 0.1638). The duration of disease did not relate to the success of UVB phototherapy. CONCLUSION: During the treatment period UVB phototherapy resulted in decreased severity of disease. However, the itching and the course of the disease were unchanged.
Pityriasis rosea is a skin disease characterized by sharply defined pruritic red patches covered by fine scales. It affects mostly adolescent and young adults. Typical lesions usually affect the trunk in a Christmas-tree pattern. The eruption usually resolves after 6 weeks but symptomatic treatment may be needed. Two patients are reported with classic presentation of pityriasis rosea except for the unusual associated palmoplantar lesions; both patients had negative RPR (with dilutions) and MHA-TP. They responded to 2-week courses of either oral erythromycin or Clarithromycin with complete resolution.
BACKGROUND: Pityriasis rosea (PR) is an acute, inflammatory disease of unknown cause. Clinical and experimental findings indicate an infectious etiology of PR. Our purpose is to examine the skin lesions and blood samples of PR patients by polymerase chain reaction (PCR) for the presence of HSV type 1 and 2 DNA. METHODS: The lesional skin biopsies from 10 patients and blood samples from two randomized patients with clinically and histologically confirmed pityriasis rosea were examined by PCR. RESULTS: No HSV 1 and HSV 2 DNA was detected in the lesional biopsy and blood samples. CONCLUSIONS: We could not identify a relationship between HSV 1, HSV 2 and PR.