Pityriasis rosea: Difference between revisions

(coding issue)
(citation)
Line 20: Line 20:


==Treatment==
==Treatment==
*Lasts 8 to 12 weeks
*Lasts 8 to 12 weeks<ref>Richard P. Usatine and Jennifer Krejci-Manwaring: Rakel: Textbook of Family Medicine, 8th ed., Saunders 2011, (Ch) 33:p720</ref>
*Reassurance about the self-limited nature
*Reassurance about the self-limited nature
*Natural sunlight may speed up resolution
*Natural sunlight may speed up resolution
*Pruritus
*Pruritus<ref>Richard P. Usatine and Jennifer Krejci-Manwaring: Rakel: Textbook of Family Medicine, 8th ed., Saunders 2011, (Ch) 33:p720</ref>
**Antihistamine, topical steroids
**Antihistamine, topical steroids
***Triamcinolone 0.1% - Adults
***Triamcinolone 0.1% - Adults

Revision as of 16:01, 4 January 2015

Background

  • Mild inflammatory exanthem
    • May be caused by HHV 6 and 7
  • Most common 10-35yr old
  • Not contagious
  • Spontaneous resolution occurs w/in 4-12wk

Diagnosis

  • Begins with single, "herald," patch (salmon-colored, fine scaling)
  • Followed in 1-2 weeks by generalized diffuse papulosquamous rash mostly on trunk
    • Secondary rash with fine scaling oval macules and plaques following Langer Lines ("Christmas tree" pattern)
  • Pruritus can be moderate to severe

DDx

  • Psoriasis
  • Tinea corporis
    • Usually not as widespread
  • Pityriasis versicolor
    • Also has fine scaling but KOH is diagnostic

Treatment

  • Lasts 8 to 12 weeks[1]
  • Reassurance about the self-limited nature
  • Natural sunlight may speed up resolution
  • Pruritus[2]
    • Antihistamine, topical steroids
      • Triamcinolone 0.1% - Adults
      • Hydrocortisone 1% - children)
    • Other
      • Zinc oxide
      • Calamine lotion
    • Systemic steroids are generally not recommended.
  • Rash or pruritus beyond 12 weeks: reconsider original diagnosis
    • Consider biopsy to confirm the diagnosis

Disposition

  • Discharge

Source

  • Tintinalli
  1. Richard P. Usatine and Jennifer Krejci-Manwaring: Rakel: Textbook of Family Medicine, 8th ed., Saunders 2011, (Ch) 33:p720
  2. Richard P. Usatine and Jennifer Krejci-Manwaring: Rakel: Textbook of Family Medicine, 8th ed., Saunders 2011, (Ch) 33:p720