Disease: Pityriasis Rosea

    Pityriasis rosea facts

    • Pityriasis rosea begins as a single, large pink patch found on the trunk called the "herald patch."
    • The herald patch is followed one to two weeks later with smaller pink patches in a "Christmas tree" configuration.
    • Pityriasis rosea is generally asymptomatic except for the appearance.
    • Pityriasis rosea is mildly itchy in 50% of cases and clears spontaneously in an average of six to eight weeks.
    • Pityriasis rosea is sometimes accompanied by mild, flu-like symptoms and may mimic fungal infection and other conditions.
    • Pityriasis rosea has no long-lasting health effects and is not directly contagious.
    • Lifelong immunity often occurs after one episode of pityriasis rosea.

    What is pityriasis rosea?

    Pityriasis rosea is a common rash usually seen in individuals between 10-35 years of age. The rash typically lasts six to eight weeks, rarely extending 12 weeks or longer. Once a person has pityriasis rosea, it generally does not recur in their lifetime.

    Pityriasis rosea characteristically begins as an asymptomatic single, large pink, scaly patch called the "herald patch" or mother patch, measuring 2-10 centimeters. The herald patch is a dry pink to red patch which appears on the back, chest, or neck and has a well-defined, scaly border.

    One to two weeks following the initial appearance of the herald patch, a person will then develop many smaller pink patches across their trunk, arms, and legs. The second stage of pityriasis rosea erupts with a large number of oval spots, ranging in diameter from 0.5 centimeter (size of a pencil eraser) to 1.5 centimeters (size of a peanut). The individual spots form a symmetrical "Christmas tree" pattern on the back with the long axis of the ovals oriented in the "Lines of Blaschko" (invisible skin lines of embryonic origin). This rash is usually limited to the trunk, arms, and legs, rarely occurring on the face and neck. Pityriasis rosea usually spares the face, hands, and feet.

    Picture of pityriasis rosea on the torso; photo courtesy of Gary W. Cole, MD, FAAD

    Who gets pityriasis rosea?

    Pityriasis rosea is, for the most part, equally common between the two sexes, although there is a slightly higher occurrence reported in women. It generally occurs in children and young adults between 10-35 years of age. Pityriasis rosea has no racial predominance. Most people only develop pityriasis rosea once in their lifetime.

    What causes pityriasis rosea?

    The exact cause of pityriasis rosea remains unknown. Most recently, pityriasis rosea has been associated most strongly with a virus from the human herpes family called human herpes virus type 6, 7, and 8. Pityriasis rosea is not caused by or known to be associated with the common types of herpes virus that causes genital, oral herpes, or varicella (chickenpox). While the mode of transmission (how it gets passed between people) of pityriasis rosea is also unknown, respiratory contact has been postulated. Pityriasis rosea does not seem to be directly or immediately contagious to close contacts or health-care providers exposed to the rash. Most people with a known exposure to pityriasis rosea do not seem to contract the rash.

    What are pityriasis rosea symptoms and signs?

    Most people do not notice any symptoms with pityriasis rosea except for the appearance of the rash itself. Mild, intermittent itching is reported in about 50% of individuals affected, especially when people exercise or take hot showers. Itching seems to increase with stress. Rarely, it is accompanied by flu-like symptoms, such as sore throat, fatigue, nausea, aching, and decreased appetite. Most people are otherwise in very good health and don't feel any other symptoms.

    How is pityriasis rosea diagnosed?

    Pityriasis rosea is usually diagnosed by the skin appearance, particularly the onset of the distinct large herald patch and the symmetrical Christmas tree presentation. Also, the herald patch tends to have a unique, fine scale with a definite border, the so-called "collarette." To rule out other types of skin disorders, a physician may scrape the skin and examine the scales under the microscope with a drop of potassium hydroxide or "KOH" to detect fungus infection that could mimic pityriasis rosea. Also, blood tests including rapid plasma reagent (RPR) may be done to detect secondary syphilis, which also may mimic pityriasis rosea. In some cases, a skin biopsy may be required to detect fungus and other types of rashes.

    What are some common misdiagnoses of pityriasis rosea?

    The first herald patch of pityriasis rosea may look very similar in appearance to ringworm (tinea corporis). Pityriasis rosea has also been mistaken with eczema and psoriasis, which can occur as similar scaly patches, but not in the same distribution as pityriasis rosea.

    Pityriasis rosea may be misdiagnosed as

    • psoriasis,
    • eczema,
    • fungal infection (tinea corporis),
    • secondary syphilis,
    • drug eruption (a diffuse body rash caused commonly by a reaction to a medications like an oral antibiotic),
    • fixed drug eruption (a single small, circular or oval patch of skin rash caused by taking a medication),
    • pityriasis lichenoides chronica,
    • parapsoriasis,
    • HIV-associated rash,
    • folliculitis.

    What is the treatment for pityriasis rosea?

    Pityriasis rosea usually requires no treatment and resolve spontaneously. Treatment is not necessary if the rash does not cause significant problems. Typically, pityriasis rosea will usually clear on its own in nine weeks without medical intervention or therapy.

    The most common symptom is itching, which can be treated with topical steroid creams (like hydrocortisone cream) and oral antihistamines (like diphenhydramine [Benadryl], loratadine [Claritin], etc.). These will not shorten the duration of the rash but will decrease the itching. Another treatment for itching is UVB light or sunlight. However, exposure to sunlight increases the risk of skin cancer. Generally, the best treatment is to avoid being overheated by reducing exercise and avoiding hot showers and baths.

    Learn more about: hydrocortisone | Benadryl | Claritin

    There has been some evidence of reduced duration of pityriasis rosea with the off-label use of the antibiotic erythromycin or off-label use of antiviral medications such as acyclovir (Zovirax) or famciclovir (Famvir). However, neither of these medications has been proven to be uniformly effective in the treatment of pityriasis rosea and they are not usually necessary or required.

    What home remedies can I use for pityriasis rosea?

    Home remedies of pityriasis rosea include taking lukewarm baths or showers, avoiding drying soaps, wearing cotton or silk clothing to reduce heat, and taking oatmeal baths. Calamine or menthol lotions can also be helpful for itching. The following are additional home remedies:

    • Lubricating with bland moisturizers
    • Steroid creams (hydrocortisone cream)
    • Diphenhydramine (Benadryl) oral pills or liquid for itching
    • Natural sunlight exposure to body parts, 10-15 minutes per day

    Is pityriasis rosea dangerous during pregnancy?

    If pityriasis rosea occurs early in pregnancy, within the first 15 weeks, there seems to be a greater chance of miscarriage. In addition, children of affected mothers may be prone to premature delivery. Since there little that can be done to prevent this disease or treat it, affected mothers are monitored closely for potential problems.

    Can pityriasis rosea be prevented?

    There is no definitive prevention for pityriasis rosea, as the cause is not yet fully known. As with most viral infections, helpful prevention tips may include good basic hygiene, hand washing, and avoidance of ill contacts and of aerosolized respiratory droplets from people coughing or sneezing.

    What is the prognosis for pityriasis rosea?

    The prognosis for pityriasis rosea is excellent as the rash usually clears even without treatment within nine weeks.

    It typically leaves no long-lasting scars, although some mild, temporary skin discoloration called post inflammatory hypopigmentation or hyperpigmentation can occur in people with darker skin. It has no known long-lasting side effects and has not been associated with any other diseases.

    Symptoms may be reduced with topical treatment or taking extra precaution to prevent overheating. Once a person has pityriasis rosea, they generally have lifelong immunity.

    Who gets pityriasis rosea?

    Pityriasis rosea is, for the most part, equally common between the two sexes, although there is a slightly higher occurrence reported in women. It generally occurs in children and young adults between 10-35 years of age. Pityriasis rosea has no racial predominance. Most people only develop pityriasis rosea once in their lifetime.

    What causes pityriasis rosea?

    The exact cause of pityriasis rosea remains unknown. Most recently, pityriasis rosea has been associated most strongly with a virus from the human herpes family called human herpes virus type 6, 7, and 8. Pityriasis rosea is not caused by or known to be associated with the common types of herpes virus that causes genital, oral herpes, or varicella (chickenpox). While the mode of transmission (how it gets passed between people) of pityriasis rosea is also unknown, respiratory contact has been postulated. Pityriasis rosea does not seem to be directly or immediately contagious to close contacts or health-care providers exposed to the rash. Most people with a known exposure to pityriasis rosea do not seem to contract the rash.

    What are pityriasis rosea symptoms and signs?

    Most people do not notice any symptoms with pityriasis rosea except for the appearance of the rash itself. Mild, intermittent itching is reported in about 50% of individuals affected, especially when people exercise or take hot showers. Itching seems to increase with stress. Rarely, it is accompanied by flu-like symptoms, such as sore throat, fatigue, nausea, aching, and decreased appetite. Most people are otherwise in very good health and don't feel any other symptoms.

    How is pityriasis rosea diagnosed?

    Pityriasis rosea is usually diagnosed by the skin appearance, particularly the onset of the distinct large herald patch and the symmetrical Christmas tree presentation. Also, the herald patch tends to have a unique, fine scale with a definite border, the so-called "collarette." To rule out other types of skin disorders, a physician may scrape the skin and examine the scales under the microscope with a drop of potassium hydroxide or "KOH" to detect fungus infection that could mimic pityriasis rosea. Also, blood tests including rapid plasma reagent (RPR) may be done to detect secondary syphilis, which also may mimic pityriasis rosea. In some cases, a skin biopsy may be required to detect fungus and other types of rashes.

    What are some common misdiagnoses of pityriasis rosea?

    The first herald patch of pityriasis rosea may look very similar in appearance to ringworm (tinea corporis). Pityriasis rosea has also been mistaken with eczema and psoriasis, which can occur as similar scaly patches, but not in the same distribution as pityriasis rosea.

    Pityriasis rosea may be misdiagnosed as

    • psoriasis,
    • eczema,
    • fungal infection (tinea corporis),
    • secondary syphilis,
    • drug eruption (a diffuse body rash caused commonly by a reaction to a medications like an oral antibiotic),
    • fixed drug eruption (a single small, circular or oval patch of skin rash caused by taking a medication),
    • pityriasis lichenoides chronica,
    • parapsoriasis,
    • HIV-associated rash,
    • folliculitis.

    What is the treatment for pityriasis rosea?

    Pityriasis rosea usually requires no treatment and resolve spontaneously. Treatment is not necessary if the rash does not cause significant problems. Typically, pityriasis rosea will usually clear on its own in nine weeks without medical intervention or therapy.

    The most common symptom is itching, which can be treated with topical steroid creams (like hydrocortisone cream) and oral antihistamines (like diphenhydramine [Benadryl], loratadine [Claritin], etc.). These will not shorten the duration of the rash but will decrease the itching. Another treatment for itching is UVB light or sunlight. However, exposure to sunlight increases the risk of skin cancer. Generally, the best treatment is to avoid being overheated by reducing exercise and avoiding hot showers and baths.

    Learn more about: hydrocortisone | Benadryl | Claritin

    There has been some evidence of reduced duration of pityriasis rosea with the off-label use of the antibiotic erythromycin or off-label use of antiviral medications such as acyclovir (Zovirax) or famciclovir (Famvir). However, neither of these medications has been proven to be uniformly effective in the treatment of pityriasis rosea and they are not usually necessary or required.

    What home remedies can I use for pityriasis rosea?

    Home remedies of pityriasis rosea include taking lukewarm baths or showers, avoiding drying soaps, wearing cotton or silk clothing to reduce heat, and taking oatmeal baths. Calamine or menthol lotions can also be helpful for itching. The following are additional home remedies:

    • Lubricating with bland moisturizers
    • Steroid creams (hydrocortisone cream)
    • Diphenhydramine (Benadryl) oral pills or liquid for itching
    • Natural sunlight exposure to body parts, 10-15 minutes per day

    Is pityriasis rosea dangerous during pregnancy?

    If pityriasis rosea occurs early in pregnancy, within the first 15 weeks, there seems to be a greater chance of miscarriage. In addition, children of affected mothers may be prone to premature delivery. Since there little that can be done to prevent this disease or treat it, affected mothers are monitored closely for potential problems.

    Can pityriasis rosea be prevented?

    There is no definitive prevention for pityriasis rosea, as the cause is not yet fully known. As with most viral infections, helpful prevention tips may include good basic hygiene, hand washing, and avoidance of ill contacts and of aerosolized respiratory droplets from people coughing or sneezing.

    What is the prognosis for pityriasis rosea?

    The prognosis for pityriasis rosea is excellent as the rash usually clears even without treatment within nine weeks.

    It typically leaves no long-lasting scars, although some mild, temporary skin discoloration called post inflammatory hypopigmentation or hyperpigmentation can occur in people with darker skin. It has no known long-lasting side effects and has not been associated with any other diseases.

    Symptoms may be reduced with topical treatment or taking extra precaution to prevent overheating. Once a person has pityriasis rosea, they generally have lifelong immunity.

    Source: http://www.rxlist.com

    Pityriasis rosea usually requires no treatment and resolve spontaneously. Treatment is not necessary if the rash does not cause significant problems. Typically, pityriasis rosea will usually clear on its own in nine weeks without medical intervention or therapy.

    The most common symptom is itching, which can be treated with topical steroid creams (like hydrocortisone cream) and oral antihistamines (like diphenhydramine [Benadryl], loratadine [Claritin], etc.). These will not shorten the duration of the rash but will decrease the itching. Another treatment for itching is UVB light or sunlight. However, exposure to sunlight increases the risk of skin cancer. Generally, the best treatment is to avoid being overheated by reducing exercise and avoiding hot showers and baths.

    Learn more about: hydrocortisone | Benadryl | Claritin

    There has been some evidence of reduced duration of pityriasis rosea with the off-label use of the antibiotic erythromycin or off-label use of antiviral medications such as acyclovir (Zovirax) or famciclovir (Famvir). However, neither of these medications has been proven to be uniformly effective in the treatment of pityriasis rosea and they are not usually necessary or required.

    Source: http://www.rxlist.com

    Health Services in

    Define Common Diseases

    Skincare Health Center helps you find information, definitaions and treatement options for most common diseases, sicknesses, illnesses and medical conditions. Find what diseases you have quick and now.