Dermatologic Emergencies

dermatology-emergencieskapak-1-0-25

Pityriasis Rosea

Burak Emre GİLİK
Sincan Training and Research Hospital, Clinic of Emergency Medicine, Ankara, Türkiye

Burhaneddin Burak YURT
Ankara Etlik City Hospital, Clinic of Emergency Medicine, Ankara, Türkiye

Gilik BE, Yurt BB. Pityriasis rosea. In: Oğuztürk H, Görmeli Kurt N, eds. Dermatologic Emergencies. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.116-20.

ABSTRACT

Pityriasis rosea (PR) is a benign, self-limiting skin condition with an unclear etiology. It frequently involves the torso and extremities and typically begins with a distinct herald patch, a red, scaly lesion that appears before the development of a broader rash. PR generally resolves on its own within 6-8 weeks. The term “pityriasis” refers to the fine, bran-like scales seen on the skin, while “rosea” denotes the pinkish hue of the lesions. Although Camille Melchoir Gibert, a French physician, first described PR in 1860, it was known earlier under different names, such as roseola annulata, a term introduced by British dermatologist Robert Willan in 1798. PR is most commonly observed in individuals aged 10-43 and tends to be more prevalent during the spring and fall. It is rare in infants and older adults, and there is no significant difference between sexes. The reactivation of human herpesviruses HHV-6 and HHV-7 is commonly suspected as a cause of PR. Additionally, PR-like rashes have been reported after vaccinations and certain medications, although these rashes often lack the herald patch typical of PR. Clinically, PR may start with mild symptoms like headache, fever, and malaise in about 5-10% of patients. The herald patch is usually a large, red plaque with fine scaling, often located on the trunk, neck, or proximal extremities. This patch is followed by smaller, oval lesions aligning with skin lines, particularly on the back, forming the “Christmas tree” pattern. Pruritus, affecting up to 75% of patients, can vary from mild to severe. Diagnosis is primarily clinical, with the herald patch being a key indicator. While skin biopsy is rarely necessary, it can help rule out other conditions like eczema, tinea corporis, or secondary syphilis. Routine lab tests are generally not required, but potassium hydroxide (KOH) preparation, syphilis serology, and throat cultures may be used to exclude other diagnoses. Treatment focuses on alleviating symptoms rather than targeting the underlying cause. There is no specific treatment for PR; the condition resolves on its own without the need for targeted therapy. Options include antihistamines for itching, topical corticosteroids for inflammation, and oatmeal baths for soothing the skin. For severe or persistent cases, antivirals like acyclovir or phototherapy might be considered. PR is not contagious and does not require isolation.

Keywords: Herpesvirus 6, human; herpesvirus 7, human; histamine H1 antagonists; pityriasis rosea; pruritus; skin diseases, papulosquamous

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