Pityriasis rosea: Difference between revisions
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==Diagnosis== | ==Diagnosis== | ||
[[File:Pityriasisrosa.jpg|thumb|Pityriasis rosea on back]] | |||
*Begins with single, "herald," patch (salmon-colored, fine scaling) | *Begins with single, "herald," patch (salmon-colored, fine scaling) | ||
**1-2 weeks prior to generalized eruption | **1-2 weeks prior to generalized eruption | ||
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*Pruritus can be moderate to severe | *Pruritus can be moderate to severe | ||
== | ==Differential Diagnosis== | ||
*Psoriasis | *[[Psoriasis]] | ||
*Tinea corporis | *[[Tinea corporis]] | ||
**Usually not as widespread | **Usually not as widespread | ||
*Pityriasis versicolor | *[[Pityriasis versicolor]] | ||
**Also has fine scaling but KOH is diagnostic | **Also has fine scaling but KOH is diagnostic | ||
{{Generalized rash DDX}} | |||
==Treatment== | ==Treatment== | ||
Revision as of 10:33, 13 January 2015
Background
- Mild inflammatory exanthem
- May be caused by HHV 6 and 7
- Most common 10-35yr old
- Not contagious
- Spontaneous resolution occurs within 4-12wk
Diagnosis
- Begins with single, "herald," patch (salmon-colored, fine scaling)
- 1-2 weeks prior to generalized eruption
- Larger lesion (Herald Patch) that resembles the later smaller lesions
- Typically on the abdomen
- Secondary maculopapular rash with plaques following Langer Lines ("Christmas tree" pattern)
- Typically follows rip distribution
- Pruritus can be moderate to severe
Differential Diagnosis
- Psoriasis
- Tinea corporis
- Usually not as widespread
- Pityriasis versicolor
- Also has fine scaling but KOH is diagnostic
Other Rash
- Acute generalized exanthematous pustulosis
- Allergic reaction
- Aphthous stomatitis
- Atopic dermatitis
- Coxsackie
- Dermatitis herpetiformis
- Exfoliative erythroderma
- Impetigo
- Pellagra
- Pityriasis rosea
- Serum Sickness
- Tinea capitus
- Tinea corporis
- Vitiligo
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.
- Antihistamine, topical steroids
- Rash or pruritus beyond 12 weeks: reconsider original diagnosis
- Consider biopsy to confirm the diagnosis
Disposition
- Discharge