What is Pityriasis Rosea?
Pityriasis rosea (PR) is a benign inflammatory skin eruption. It belongs to papulosquamous family of dermatological condition. Pityriasis rosea’s name means “fine pink scale”. It is a very common skin disorder which tends to manifest mostly in children and young adults.
How does Pityriasis Rosea Clinically Present?
Pityriasis rosea (PR) has a very distinct skin manifestation. Initially, patients notice a very prominent well demarcated annular (circular) 2-10 cm scaly patch (rash) over their chest or trunk. The back areas is the most common site of initial presentation. This initial eruption is called herald patch. After few days, the oval or round skin eruption with fine scaling and central wrinkling spreads and cover the entire back or chest area. It follows the rib cage lines, hence the characteristic Christmas tree pattern can be appreciated over back area. It tends to spread for one to two weeks after initial herald patch presentation. A characteristic feature of secondary eruption is the appearance of the scale, with edges peripherally attached and lifted up near the center of the lesion
Itch is not a prominent symptoms associated with Pityriasis rosea, however 25-75% of patients may express some concerns about pruritus (ongoing itch). It tends to last as long as 6-8 weeks and then gradually will fade without any active treatment.
Association with Pityriasis Rosea
It is not clear the underlying cause of pityriasis rosea, however it is widely acceptable that viral infections, especially Human Herpes virus 7, 6, 8 as well as H1N1 influenza A virus play a role in developing pityriasis rosea
Treatments of Pityriasis Rosea
As we mentioned, pityriasis rosea tends to resolve by itself in 6-8 weeks. However, some patients still suffer from significant pruritus (itch). In order to resolve the itch, over the counter products can be valuable including
- Moisturizers: CeraVe or Cetaphil are designed for sensitive skin and our board certified dermatologist regularly advise the pediatrics (infants, children) or adult patients to use them on regular basis, at least twice a day.
- Calamine lotion can also be beneficial in reducing itch
- Over the counter anti-histamines including Loratadine (Claritin), Cetirizine, Allegra can provide temporarily relief
If the itch is very bothersome, you may need to seek help from a board certified dermatologist in Canada to address your ongoing symptoms, through using teledermatology, they can prescribe the following medications
- Topical steroid can be applied once or twice a day over most body surface area (not on the face or skin folds) for few days or weeks to address the ongoing itch
- Oral steroids can also be prescribed in more severe cases for patients who can’t sleep at night time or pityriasis rosea is significantly affecting their quality of life
- Phototherapy (light therapy) is also another beneficial treatment in which patients stand in a box with ultraviolet lamp (not a tanning bed) for few minutes, two or three times per week for 4-5 weeks
- Acyclovir or Erythromycin oral medications: since it is not clear the underlying etiology of pityriasis rosea, there are some case reports indicated that patients may benefit from oral antibiotic or antiviral to address the pityriasis Rosea. However, it is not generally recommended by our board certified dermatologist.
Complications of Pityriasis Rosea
There is no significant complications associated with pityriasis rosea, however some patients may experience:
- Post-inflammatory pigment changes can be observed. The area which is covered with scaly rash may resolve with darkening (hyperpigmentation) or lack of color (hypopigmentation). These color changes are temporarily and following strict sun avoidance would assists in resolving the discoloration. You can easily submit your case using Teledermatology and our board certified dermatologist can prescribe appropriate topical medications in less than 12 hrs to start getting your pigmentation treated
- As we discussed, the itch associated with pityriasis rosea can be so severe that can impair patent’s quality of life. These patients can contact board certified dermatologist at RemoteDerm to get a consultation and resolve their issues right away.
Prevention of Pityriasis Rosea
Unfortunately, there is no effective way to prevent developing pityriasis rosea
If you are seeing similar signs and symptoms and suspect Pityriasis rosea, do not worry! because you can get help from board-certified dermatologists at RemoteDerm without needing to reserve a visit. Here we will diagnose and guide you through the treatment process based on your specific condition.