1. Pityriasis Rosea
Husein Oozeerally

2. Pityriasis rosea Pityriasis: fine scales Rosea: rose coloured or pink
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” Cluster of small oval spots (mimic acne)
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

11. 4 to 6 weeks
Begins to fade
Lasts average months

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

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

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

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

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