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Pityriasis rosea

Authors
Adam O Goldstein, MD, MPH
Beth G Goldstein, MD
Section Editors
Robert P Dellavalle, MD, PhD, MSPH
Moise L Levy, MD
Deputy Editor
Abena O Ofori, MD

INTRODUCTION

Pityriasis rosea (PR) is an acute, self-limited, exanthematous skin disease characterized by the appearance of slightly inflammatory, oval, papulosquamous lesions on the trunk and proximal areas of the extremities (picture 1A-E). The diagnosis and management of this disorder are reviewed here.

ETIOLOGY

A viral etiology for pityriasis rosea (PR) has been hypothesized based upon the following observations:

PR is sometimes preceded by a prodrome.

It occasionally occurs in small case clusters.

It has not been shown to be associated with bacterial or fungal organisms.

                 

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Literature review current through: Nov 2016. | This topic last updated: Mon Aug 22 00:00:00 GMT+00:00 2016.
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References
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  1. el-Shiemy S, Nassar A, Mokhtar M, Mabrouk D. Light and electron microscopic studies of pityriasis rosea. Int J Dermatol 1987; 26:237.
  2. Drago F, Ranieri E, Malaguti F, et al. Human herpesvirus 7 in patients with pityriasis rosea. Electron microscopy investigations and polymerase chain reaction in mononuclear cells, plasma and skin. Dermatology 1997; 195:374.
  3. Drago F, Broccolo F, Rebora A. Pityriasis rosea: an update with a critical appraisal of its possible herpesviral etiology. J Am Acad Dermatol 2009; 61:303.
  4. Kempf W, Adams V, Kleinhans M, et al. Pityriasis rosea is not associated with human herpesvirus 7. Arch Dermatol 1999; 135:1070.
  5. Watanabe T, Kawamura T, Jacob SE, et al. Pityriasis rosea is associated with systemic active infection with both human herpesvirus-7 and human herpesvirus-6. J Invest Dermatol 2002; 119:793.
  6. Broccolo F, Drago F, Careddu AM, et al. Additional evidence that pityriasis rosea is associated with reactivation of human herpesvirus-6 and -7. J Invest Dermatol 2005; 124:1234.
  7. Mubki TF, Bin Dayel SA, Kadry R. A case of Pityriasis rosea concurrent with the novel influenza A (H1N1) infection. Pediatr Dermatol 2011; 28:341.
  8. Kwon NH, Kim JE, Cho BK, Park HJ. A novel influenza a (H1N1) virus as a possible cause of pityriasis rosea? J Eur Acad Dermatol Venereol 2011; 25:368.
  9. Prantsidis A, Rigopoulos D, Papatheodorou G, et al. Detection of human herpesvirus 8 in the skin of patients with pityriasis rosea. Acta Derm Venereol 2009; 89:604.
  10. Blauvelt A. Pityriasis rosea. In: Fitzpatrick's Dermatology in General Medicine, 7th ed, Wolf K, Goldsmith LA, Katz SI, et al. (Eds), McGraw Hill, New York 2008. p.362.
  11. Trager JD. What's your diagnosis? Scaly pubic plaques in a 2-year-old girl--or an "inverse" rash. J Pediatr Adolesc Gynecol 2007; 20:109.
  12. Chuh AA. Quality of life in children with pityriasis rosea: a prospective case control study. Pediatr Dermatol 2003; 20:474.
  13. Browning JC. An update on pityriasis rosea and other similar childhood exanthems. Curr Opin Pediatr 2009; 21:481.
  14. Wilkinson SM, Smith AG, Davis MJ, et al. Pityriasis rosea and discoid eczema: dose related reactions to treatment with gold. Ann Rheum Dis 1992; 51:881.
  15. Buckley C. Pityriasis rosea-like eruption in a patient receiving omeprazole. Br J Dermatol 1996; 135:660.
  16. Gupta AK, Lynde CW, Lauzon GJ, et al. Cutaneous adverse effects associated with terbinafine therapy: 10 case reports and a review of the literature. Br J Dermatol 1998; 138:529.
  17. Spelman LJ, Robertson IM, Strutton GM, Weedon D. Pityriasis rosea-like eruption after bone marrow transplantation. J Am Acad Dermatol 1994; 31:348.
  18. Durusoy C, Alpsoy E, Yilmaz E. Pityriasis rosea in a patient with Behçet's disease treated with interferon alpha 2A. J Dermatol 1999; 26:225.
  19. Yosipovitch G, Kuperman O, Livni E, et al. [Pityriasis rosea-like eruption after anti-inflammatory and antipyretic medication]. Harefuah 1993; 124:198.
  20. Ghersetich I, Rindi L, Teofoli P, et al. [Pityriasis rosea-like skin eruptions caused by captopril]. G Ital Dermatol Venereol 1990; 125:457.
  21. Helfman RJ, Brickman M, Fahey J. Isotretinoin dermatitis simulating acute pityriasis rosea. Cutis 1984; 33:297.
  22. Honl BA, Keeling JH, Lewis CW, Thompson IM. A pityriasis rosea-like eruption secondary to bacillus Calmette-Guérin therapy for bladder cancer. Cutis 1996; 57:447.
  23. Chuh A, Zawar V, Sciallis G, Kempf W. A position statement on the management of patients with pityriasis rosea. J Eur Acad Dermatol Venereol 2016; 30:1670.
  24. Singh S, Anurag, Tiwary NK. Acyclovir is not effective in pityriasis rosea: Results of a randomized, triple-blind, placebo-controlled trial. Indian J Dermatol Venereol Leprol 2016; 82:505.
  25. Rassai S, Feily A, Sina N, Abtahian S. Low dose of acyclovir may be an effective treatment against pityriasis rosea: a random investigator-blind clinical trial on 64 patients. J Eur Acad Dermatol Venereol 2011; 25:24.
  26. Ganguly S. A Randomized, Double-blind, Placebo-Controlled Study of Efficacy of Oral Acyclovir in the Treatment of Pityriasis Rosea. J Clin Diagn Res 2014; 8:YC01.
  27. Drago F, Vecchio F, Rebora A. Use of high-dose acyclovir in pityriasis rosea. J Am Acad Dermatol 2006; 54:82.
  28. Amatya A, Rajouria EA, Karn DK. Comparative study of effectiveness of oral acyclovir with oral erythromycin in the treatment of Pityriasis rosea. Kathmandu Univ Med J (KUMJ) 2012; 10:57.
  29. Zhang Y, Schols D, De Clercq E. Selective activity of various antiviral compounds against HHV-7 infection. Antiviral Res 1999; 43:23.
  30. De Clercq E, Naesens L, De Bolle L, et al. Antiviral agents active against human herpesviruses HHV-6, HHV-7 and HHV-8. Rev Med Virol 2001; 11:381.
  31. Das A, Sil A, Das NK, et al. Acyclovir in pityriasis rosea: An observer-blind, randomized controlled trial of effectiveness, safety and tolerability. Indian Dermatol Online J 2015; 6:181.
  32. Leenutaphong V, Jiamton S. UVB phototherapy for pityriasis rosea: a bilateral comparison study. J Am Acad Dermatol 1995; 33:996.
  33. Arndt KA, Paul BS, Stern RS, Parrish JA. Treatment of pityriasis rosea with UV radiation. Arch Dermatol 1983; 119:381.
  34. Valkova S, Trashlieva M, Christova P. UVB phototherapy for Pityriasis rosea. J Eur Acad Dermatol Venereol 2004; 18:111.
  35. Jairath V, Mohan M, Jindal N, et al. Narrowband UVB phototherapy in pityriasis rosea. Indian Dermatol Online J 2015; 6:326.
  36. Castanedo-Cazares JP, Lepe V, Moncada B. Should we still use phototherapy for Pityriasis rosea? Photodermatol Photoimmunol Photomed 2003; 19:160.
  37. Chuh A. Narrow band UVB phototherapy and oral acyclovir for pityriasis rosea. Photodermatol Photoimmunol Photomed 2004; 20:64.
  38. Lim SH, Kim SM, Oh BH, et al. Low-dose Ultraviolet A1 Phototherapy for Treating Pityriasis Rosea. Ann Dermatol 2009; 21:230.
  39. Sharma PK, Yadav TP, Gautam RK, et al. Erythromycin in pityriasis rosea: A double-blind, placebo-controlled clinical trial. J Am Acad Dermatol 2000; 42:241.
  40. Chuh AA, Dofitas BL, Comisel GG, et al. Interventions for pityriasis rosea. Cochrane Database Syst Rev 2007; :CD005068.
  41. Rasi A, Tajziehchi L, Savabi-Nasab S. Oral erythromycin is ineffective in the treatment of pityriasis rosea. J Drugs Dermatol 2008; 7:35.
  42. Amer A, Fischer H. Azithromycin does not cure pityriasis rosea. Pediatrics 2006; 117:1702.
  43. Pandhi D, Singal A, Verma P, Sharma R. The efficacy of azithromycin in pityriasis rosea: a randomized, double-blind, placebo-controlled trial. Indian J Dermatol Venereol Leprol 2014; 80:36.
  44. Ahmed N, Iftikhar N, Bashir U, et al. Efficacy of clarithromycin in pityriasis rosea. J Coll Physicians Surg Pak 2014; 24:802.
  45. Drago F, Rebora A. Treatments for pityriasis rosea. Skin Therapy Lett 2009; 14:6.
  46. Drago F, Broccolo F, Javor S, et al. Evidence of human herpesvirus-6 and -7 reactivation in miscarrying women with pityriasis rosea. J Am Acad Dermatol 2014; 71:198.