Pityriasis Rosea–It starts with a Herald Patch…

Pityriasis Rosea (PR) is an inflammatory eruption characterized by salmon-colored papules and macular lesions that are at first discrete but may become more confluent.  It begins with a single “herald” or “mother” patch that often is the largest lesion.  Subsequently the patient develops generalized plaques which are oval or circinate and covered with finely crinkled, dry epidermis, which often desquamates, leaving a fine collarette of scale.  This collarette of scale has been referred to as “trailing scale” and “fine cigarette paper scale.”

The eruption spreads rapidly and can last between 6-12 weeks.  It most often affects teenagers and young adults but it can affect males and females of any age.  Black children are particularly predisposed.

It is believed to be related to a viral infection, but it has not been proven so.  Many patients note the onset after having an upper respiratory tract infection (URI).  Although it can often look very impressive, most patients do not require any form of treatment.  CAVEAT:  In patients of child bearing age one must consider secondary syphilis (Lues) in the differential diagnosis of PR.  Clue–always check the palms and soles…  I will review Lues in another blog.  For more information on PR click HERE.