By Disease Name > Pityriasis Rosea

Pityriasis Rosea

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•AKA erythema annulatum
•HHV-7
•Fall and spring
•Short-sleeve turtle neck distribution
•interval between herald patch and secondary eruption is between 2 days and 2 months
•Secondary eruption typically lasts 4 to 6 weeks (but can last up to 12 weeks)
•"PR that lingers is small plaque parapsoriasis" - Dr. Fisher I would go further and say "PR that lingers is small plaque parapsoriasis in an adult ,and PLC in a child"
•recurrence seems to be quite common

 

 

atypical PR:

•PR inversa – distribution is exclusively peripheral (or intertriginous)
•papular PR - generalized tiny papules instead of annuli
•atypical morphology – macules may lack scaling, papules may be follicular; vesicular type = uncommon

 

histology:

•focal parakeratosis (in mounds)
•focal spongiosis
•superficial perivascular infiltrate
•indistinguishable from superficial gyrate erythema (erythema annulare centrifugum)

 

hmtoggle_plus1ddx of “christmas tree” eruptions:
•erythema dyschromicum perstans (distinct morphology)
•lichen planus and lichenoid reactions (lichen pigmentosus) with PR distribution are often caused by drugs
•KS/ UP (though distinct morphology)
•pityriasis lichenoides

 

hmtoggle_plus1ddx of annular eruptions:
•pityriasis alba – longer course
•nummular eczema – can cause diagnostic difficulties when localized to the trunk
•seborrheic dermatitis – as a rule the scalp and face show the typical picture of seborrheic dermatitis
•superficial tinea

 

 

hmtoggle_plus1ddx of papular eruptions:
•drug eruption
•EM of the small lesion type
•Gianotti-Crosti syndrome (vs. inverse PR)
•guttate psoriasis
•secondary syphilis (check palms, soles, mucous membranes)