- Adam O Goldstein, MD, MPH
Adam O Goldstein, MD, MPH
- Department of Family Medicine
- University of North Carolina at Chapel Hill
- Beth G Goldstein, MD
Beth G Goldstein, MD
- Adjunct Clinical Assistant Professor
- Department of Dermatology
- University of North Carolina at Chapel Hill
- Section Editors
- Robert P Dellavalle, MD, PhD, MSPH
Robert P Dellavalle, MD, PhD, MSPH
- Section Editor — General Dermatology
- Professor of Dermatology and Public Health
- University of Colorado School of Medicine
- Colorado School of Public Health
- Chief, Dermatology Service
- US Department of Veterans Affairs
- Eastern Colorado Health Care System
- Moise L Levy, MD
Moise L Levy, MD
- Section Editor — Pediatric Dermatology
- Professor of Pediatrics and Medicine (Dermatology)
- Dell Medical School, University of Texas, Austin
- Clinical Professor of Dermatology and Pediatrics
- Baylor College of Medicine
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.
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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- 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.
- Kempf W, Adams V, Kleinhans M, et al. Pityriasis rosea is not associated with human herpesvirus 7. Arch Dermatol 1999; 135:1070.
- 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.
- 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.
- 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.
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- 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.
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- 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.
- 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.
- 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.
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- 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.
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- 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.
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- Arndt KA, Paul BS, Stern RS, Parrish JA. Treatment of pityriasis rosea with UV radiation. Arch Dermatol 1983; 119:381.
- Valkova S, Trashlieva M, Christova P. UVB phototherapy for Pityriasis rosea. J Eur Acad Dermatol Venereol 2004; 18:111.
- Jairath V, Mohan M, Jindal N, et al. Narrowband UVB phototherapy in pityriasis rosea. Indian Dermatol Online J 2015; 6:326.
- Castanedo-Cazares JP, Lepe V, Moncada B. Should we still use phototherapy for Pityriasis rosea? Photodermatol Photoimmunol Photomed 2003; 19:160.
- Chuh A. Narrow band UVB phototherapy and oral acyclovir for pityriasis rosea. Photodermatol Photoimmunol Photomed 2004; 20:64.
- Lim SH, Kim SM, Oh BH, et al. Low-dose Ultraviolet A1 Phototherapy for Treating Pityriasis Rosea. Ann Dermatol 2009; 21:230.
- 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.
- Chuh AA, Dofitas BL, Comisel GG, et al. Interventions for pityriasis rosea. Cochrane Database Syst Rev 2007; :CD005068.
- Rasi A, Tajziehchi L, Savabi-Nasab S. Oral erythromycin is ineffective in the treatment of pityriasis rosea. J Drugs Dermatol 2008; 7:35.
- Amer A, Fischer H. Azithromycin does not cure pityriasis rosea. Pediatrics 2006; 117:1702.
- 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.
- Ahmed N, Iftikhar N, Bashir U, et al. Efficacy of clarithromycin in pityriasis rosea. J Coll Physicians Surg Pak 2014; 24:802.
- Drago F, Rebora A. Treatments for pityriasis rosea. Skin Therapy Lett 2009; 14:6.
- 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.
- CLINICAL FEATURES
- Differential diagnosis
- General approach
- - Patient/parent education
- - Pruritus
- Severe cases
- - Acyclovir
- - Phototherapy
- Other therapy
- - Macrolide antibiotics
- - Systemic glucocorticoids
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS