Pityriasis Rosea

 

Pityriasis Rosea

Pityriasis Rosea is a self-limiting, papulosquamous skin eruption, likely associated with reactivation of Human Herpesvirus 7 (HHV-7) or HHV-6.

Clinical Course

  • Herald Patch: The initial finding: a solitary, large, salmon-colored, oval plaque with a collarette of scale.
  • Generalized Eruption: Follows 1–2 weeks later; smaller, similar lesions are distributed along skin tension lines on the trunk, often described as a “Christmas Tree” pattern.
  • Duration: Typically resolves spontaneously within 6–8 weeks.

Diagnostic & Management Pearls

Key Concept Details
Diagnosis Clinical: No biopsy or serology required in classic cases.
Treatment Reassurance; symptomatic treatment for pruritus (e.g., antihistamines or topical steroids).
High-Yield Exam Pearl:

  • Differential: A generalized scaling rash must always prompt a search for Secondary Syphilis. If a patient presents with a rash on the trunk and an “allergic” presentation, always check palms, soles, and history for a painless chancre.
  • Herald Patch: Remember it is solitary and precedes the trunk-dominant rash by days to weeks.