An acute, self-limiting, inflammatory skin disease, pityriasis rosea usually produces a “herald” patch — which usually goes undetected — followed by a generalized eruption of papulosquamous lesions.
The cause of pityriasis rosea is unknown, but the brief course of the disease and the virtual absence of recurrence suggest a viral agent (herpes virus 7 is suspected) or an autoimmune disorder.
Although this noncontagious disorder may develop at any age, it’s most apt to occur in adolescents and young adults. Incidence rises in the spring and fall.
Pityriasis typically begins with an erythematous “herald” patch, which may appear anywhere on the body, although it occurs most commonly on the trunk. Although this slightly raised, oval lesion is about 2 to 6 cm in diameter, approximately 25% of patients don’t notice it. A few days to several weeks later, yellow-tan or erythematous patches with scaly edges (about 0.5 to 1 cm in diameter) erupt on the trunk and extremities — and, rarely, on the face, hands, and feet in adolescents. Eruption continues for 7 to 10 days, and the patches persist for 2 to 6 weeks. Occasionally, these patches are macular, vesicular, or urticarial. A characteristic of this disease is the arrangement of lesions, which produces a pattern similar to that of a pine tree. Accompanying pruritus, if present, is usually mild but may be severe.
Characteristic skin lesions support the diagnosis. Differential diagnosis must also rule out secondary syphilis (through serologic testing), dermatophytosis, and drug reaction.
Treatment focuses on relief of pruritus, with emollients, oatmeal baths, antihistamines, topical steroids, and occasionally exposure to ultraviolet light or sunlight. Rarely, if inflammation is severe, systemic corticosteroids may be required.
❑ Reassure the patient that pityriasis rosea isn’t contagious, spontaneous remission usually occurs in 4 to 12 weeks, and lesions generally don’t recur.
❑ Urge the patient not to scratch. Advise him to avoid hot baths because they may intensify itching. Encourage the use of antipruritics.
Review other book chapters online related to Pityriasis Rosea:
Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.
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More About This Book:
Title: Professional Guide to Diseases (Eighth Edition) Authors: Springhouse Publisher: Lippincott Williams & Wilkins Copyright: 2005 ISBN: 1-58255-370-X 
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