Pityriasis Rosea

Basics

Description

  • A self-limited skin exanthem of unknown origin primarily affecting children and young adults, with peak ages 10–35 yr
  • Skin findings often begin with an isolated “herald patch,” an ovoid, erythematous, scaly plaque typically on the trunk
  • A secondary eruption usually follows, where multiple similar, but smaller, lesions appear along the Langer lines of the trunk and proximal extremities in a symmetric “Christmas-tree” pattern
  • Nearly 80% of symptoms resolve within 2 mo
  • 20% of patients will present with an atypical presentation
  • Not contagious

Etiology

  • Unknown, although there is weak evidence for a viral etiology such as HHV-6, HHV-7, HHV-8, and COVID-19
  • Many medications have been associated with a pityriasis-like reaction:
    • Barbiturates
    • Captopril
    • Omeprazole
    • Clonidine
    • Gold injections
    • Isotretinoin
    • Metronidazole
    • Bismuth
    • Hepatitis B and COVID-19 vaccine
    • Imatinib (Gleevec)
    • Interferon
  • Eczema, asthma, and underlying malignancies may be weakly associated

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