P. Treadwell et al. (eds.)Atlas of Adolescent Dermatologyhttps://doi.org/10.1007/978-3-030-58634-8_14

14. Pityriasis Rosea

Patricia Treadwell¹

(1)

Department of Dermatology, Indiana University School of Medicine, Indianapolis, IN, USA

Patricia Treadwell

Email: ptreadwe@iupui.edu

Keywords

Pityriasis roseaPapulosquamousHerald patchHHV

14.1 Introduction

Pityriasis rosea (PR) is a benign papulosquamous disorder that can be seen in adolescents.

14.2 Epidemiology

The most common age group affected are 13–36-year-old individuals. There has been speculation that PR is associated with a viral illness. There is a seasonal variation in number of cases and human herpes virus (HHV) 6, 7, and 8 have been isolated in small studies of patients with PR [1, 2].

14.3 Clinical Findings

The initial lesion in 88% of patients is termed a “herald patch.” The “herald patch” is most often an erythematous somewhat raised lesion with overlying scale. The “herald patch” typically measures 2–5 cm in diameter and can occur anywhere on the body. After 10–14 days, multiple smaller (5–10 mm), oval-shaped lesions are noted primarily on the trunk and proximal extremities oriented parallel to Langer lines (Fig. 14.1). In skin of color, the lesions may be more papular and/or crusted. The lesions are usually present for 6–8 weeks.

../images/446896_1_En_14_Chapter/446896_1_En_14_Fig1_HTML.png — Fig. 14.1
Pityriasis rosea lesions with erythema and scale, the lesions (especially on the flank) follow Langer lines

14.4 Laboratory

No laboratory testing is diagnostic. Serologic tests for syphilis are recommended if suspected by medical history and/or if lesions are noted on the palms and soles.

14.5 Treatment

Since the disorder resolves on its own, treatment is often not necessary. Topical or systemic anti-pruritics may be prescribed if the itching is significant.

14.6 Prognosis

As mentioned above, the disorder resolves spontaneously. In skin of color, post inflammatory dyspigmentation can be seen.