Pityriasis rosea: Difference between revisions
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==Background== | ==Background== | ||
{{Skin anatomy background images}} | |||
*Mild inflammatory exanthem | *Mild inflammatory exanthem | ||
**May be caused by HHV 6 and 7 | **May be caused by HHV 6 and 7 | ||
**70% preceded by URI <ref> Sharma PK, Yadav TP, Gautam RK, Taneja N, Satyanarayana L (2000). "Erythromycin in pityriasis rosea: A double-blind, placebo-controlled clinical trial". Journal of the American Academy of Dermatology 42 (2 | **70% preceded by URI <ref> Sharma PK, Yadav TP, Gautam RK, Taneja N, Satyanarayana L (2000). "Erythromycin in pityriasis rosea: A double-blind, placebo-controlled clinical trial". Journal of the American Academy of Dermatology 42 (2 Patient 1): 241–4. PMID 1064267 </ref> | ||
*Most common 10-35yr old | *Most common 10-35yr old | ||
*Not contagious | *Not contagious | ||
*Spontaneous resolution occurs within 4-12wk | *Spontaneous resolution occurs within 4-12wk | ||
== | ==Evaluation== | ||
[[File:Pityriasisrosa.jpg|thumb|Pityriasis rosea on back]] | [[File:Pityriasisrosa.jpg|thumb|Pityriasis rosea on back]] | ||
[[File:Pityriasisfront.jpg|thumb|Pityriasis rosea on front]] | [[File:Pityriasisfront.jpg|thumb|Pityriasis rosea on front]] | ||
[[File:Heraldpatch2.jpg|thumb|Herald patch]] | [[File:Heraldpatch2.jpg|thumb|Herald patch]] | ||
*Begins with single, "herald," patch (salmon-colored, fine scaling) | *Begins with single, "herald,"[[rash|patch]] (salmon-colored, fine scaling) | ||
**1-2 weeks prior to generalized eruption | **1-2 weeks prior to generalized eruption | ||
**Larger lesion (Herald Patch) that resembles the later smaller lesions | **Larger lesion (Herald Patch) that resembles the later smaller lesions | ||
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*Secondary maculopapular rash with plaques following Langer Lines ("Christmas tree" pattern) | *Secondary maculopapular rash with plaques following Langer Lines ("Christmas tree" pattern) | ||
**Typically follows rip distribution | **Typically follows rip distribution | ||
*Pruritus can be moderate to severe | *[[Pruritus]] can be moderate to severe | ||
*Consider RPR or VDRL to | *Consider RPR or VDRL to rule out syphilis | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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**Also has fine scaling but KOH is diagnostic | **Also has fine scaling but KOH is diagnostic | ||
{{ | {{Plaques DDX}} | ||
==Management== | ==Management== | ||
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*Natural sunlight may speed up resolution | *Natural sunlight may speed up resolution | ||
*Pruritus<ref>Richard P. Usatine and Jennifer Krejci-Manwaring: Rakel: Textbook of Family Medicine, 8th ed., Saunders 2011, (Ch) 33:p720</ref> | *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 | ||
***Hydrocortisone 1% - | ***[[Hydrocortisone]] 1% - Children | ||
**Other | **Other | ||
***Zinc oxide | ***Zinc oxide | ||
| Line 47: | Line 48: | ||
*Discharge | *Discharge | ||
== | ==See Also== | ||
==External Links== | |||
==References== | |||
<references/> | <references/> | ||
[[Category: | [[Category:Pediatrics]] | ||
[[Category: | [[Category:Dermatology]] | ||
[[Category:ID]] | |||
Latest revision as of 17:28, 11 December 2024
Background
- Mild inflammatory exanthem
- May be caused by HHV 6 and 7
- 70% preceded by URI [1]
- Most common 10-35yr old
- Not contagious
- Spontaneous resolution occurs within 4-12wk
Evaluation
- 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
- Consider RPR or VDRL to rule out syphilis
Differential Diagnosis
- Psoriasis
- Tinea corporis
- Usually not as widespread
- Pityriasis versicolor
- Also has fine scaling but KOH is diagnostic
Plaques
- Psoriasis
- Bowen disease
- Discoid lupus erythematosus
- Drug eruption
- Erythema annulare centrifugum
- Lichen planus
- Lichen simplex chronicus
- Nummular dermatitis (nummular eczema)
- Parapsoriasis
- Pityriasis rosea
- Seborrheic dermatitis
Management
- Lasts 8 to 12 weeks[2]
- Reassurance about the self-limited nature
- Natural sunlight may speed up resolution
- Pruritus[3]
- 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
See Also
External Links
References
- ↑ Sharma PK, Yadav TP, Gautam RK, Taneja N, Satyanarayana L (2000). "Erythromycin in pityriasis rosea: A double-blind, placebo-controlled clinical trial". Journal of the American Academy of Dermatology 42 (2 Patient 1): 241–4. PMID 1064267
- ↑ Richard P. Usatine and Jennifer Krejci-Manwaring: Rakel: Textbook of Family Medicine, 8th ed., Saunders 2011, (Ch) 33:p720
- ↑ Richard P. Usatine and Jennifer Krejci-Manwaring: Rakel: Textbook of Family Medicine, 8th ed., Saunders 2011, (Ch) 33:p720