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Pityriasis Rosea

Pityriasis Rosea. Husein Oozeerally. Pityriasis rosea. Originally described by Camille Melchior Gibert in 1860 Pityriasis: fine scales Rosea: rose coloured or pink Benign Self limiting but associated with increased miscarriage in first 15 wks of pregnancy. Pityriasis Rosea.

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Pityriasis Rosea

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  1. Pityriasis Rosea Husein Oozeerally

  2. Pityriasis rosea • Originally described by Camille • Melchior Gibert in 1860 • Pityriasis: fine scales • Rosea: rose coloured or pink • Benign Self limiting but associated with increased miscarriage in first 15 wks of pregnancy

  3. Pityriasis Rosea • 2 % of OP visits • F>M • Children and young adults (10-35yr) • 0.15% prevalence • No racial variation (lesion colour) • Seasonal outbreaks and climatic variation • Institutional outbreaks

  4. Pityriasis Rosea • Uncertain cause • Possible viral trigger • HHV 6 HHV 7 • Not contagious • Life long immunity after outbreak

  5. Initially…. • Prodromal symptoms • Malaise • Headache • Mild constitutional symptoms • Respiratory infection in 69%

  6. Then.. • “Herald patch” • Large (2 - 10cm) • Isolated • Single or multiple • Oval • Pink • Scaly • Central clearing occasionally (mimic tinea) • Cluster of small oval spots (mimic acne) • Location abdomen (occn armpit)

  7. Images

  8. 5 to 10 days later • Smaller lesion appear on the body • Trunk (sometimes thighs) • Occasionally on face, palms and soles • African american boys • Termed inverse pityriasis

  9. Progression • Small round papules • > enlarge to1-2cm ovals • Scaly surface • Raised or flat • Hyper or hypo pigmented • Run along dermatomal lines/ribs giving Christmas tree distribution

  10. 4 to 6 weeks • Begins to fade • Lasts average 2 - 3 months

  11. Differential • Viral Exanthems • Measle like drug eruptions • Secondary syphilis • Tinea (KOH test negative) • Guttate psoriasis

  12. Diagnosis • Experienced Clinician!!! • A biopsy of lesion show erthrocytes with dermal papillae and dyskeratotic cells within the dermis

  13. Management No treatment but……. Symptom relief from itching Avoided soap Oral erythromycin UVB light (used in the first week)may hasten the disappearance

  14. The END • Summary • Common • Benign • Self limiting (no tx)

  15. References • Atlas of Pedistric Physical Diagnosis Zitelli 5 ed • Emedicine Medscape www

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