Pityriasis rosea

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

• Pruritus
  • Antihistamine, topical steroids
    • Triamcinolone 0.1% - Adults
    • Hydrocortisone 1% - children)
• Natural sunlight may speed up resolution

Disposition

• Discharge

Source

Tintinalli