Pityriasis Rosea

Farinoosh Dadrass, MS and Wendy Kim, DO edited by Meredith Wagner, MD FAAD

Definition:

Fairly common rash occurring on the chest and back in older children and adults.
Presents as scaly pink to tan patches, sometimes itchy.
Some individuals experience cold-like symptoms before or during the rash (fever, fatigue, headaches, sore throat, nausea, joint pain).

Appearance and Progression:

Begins with a larger, scaly, oval lesion called a "herald patch" on the chest, stomach, back, upper arm, or thigh.
Herald patch is purple or red-brown in skin of color.
Smaller versions of the herald patch appear on the body one or two weeks later.
Rash may be mistaken for hives or eczema.
In children, patches are commonly found in the groin region and underarms, less commonly on the hands and feet. In darker-skinned children, the rash may occur on the face and scalp.

Duration:

Pityriasis rosea can last from a few weeks to over five months before resolving.
Discoloration may be left behind, especially in patients with skin of color, but it usually resolves with time.

Cause:

The exact cause is not fully understood.
Possibly caused by a virus, but it is not considered contagious.

Diagnosis:

Dermatologists can typically diagnose pityriasis rosea based on the appearance of the rash.
Scraping or biopsy may be performed in some cases to confirm the diagnosis.
Pregnant individuals with pityriasis rosea should consult their obstetrician and dermatologist due to the risk of spontaneous abortions.

Treatment:

Often not necessary as the condition tends to resolve on its own.
Symptomatic relief can be achieved with fragrance-free soaps, moisturizers, anti-itch creams, and over-the-counter antihistamines.
Lukewarm water is recommended for baths or showers.
Prescription steroid cream, oral medication, and light therapy may be considered for prolonged or severe symptoms.

It's important for individuals experiencing symptoms to consult with a healthcare professional for an accurate diagnosis and appropriate management.

Additional Resources

References

Schadt C. Pityriasis Rosea. JAMA Dermatol. 2018;154(12):1496. doi:10.1001/jamadermatol.2018.3290
Villalon-Gomez JM. Pityriasis Rosea: Diagnosis and Treatment. Am Fam Physician. 2018;97(1):38-44.

Pityriasis Rosea - Easy Summary:

What is it?

Pityriasis rosea is a common rash on the chest and back in older kids and adults.
It looks like pink or tan patches that might be itchy.
Some people feel like they have a cold before or during the rash.

How does it look?

Starts with a big, scaly patch called a "herald patch" on the chest, stomach, back, or arms.
In people with darker skin, the herald patch can be purple or red-brown.
Smaller patches come out a week or two later.
People might think it's hives or eczema.
In kids, the patches are often in the groin and underarms, and in darker-skinned kids, it can be on the face and scalp.

How long does it last?

The rash can stay for a few weeks to over five months.
Sometimes, it leaves a mark, especially in people with darker skin, but it usually goes away.

What causes it?

We're not exactly sure what causes it, but it's not something you can catch from others.

How is it diagnosed?

Doctors can usually tell by looking at the rash.
Sometimes, they might need to scrape or check a small piece of the rash.
If someone is pregnant and has this rash, they should talk to their doctor.

How is it treated?

Often, it goes away by itself and doesn't need special treatment.
To feel better, people can use soaps, creams, and medicine recommended by the doctor.
Taking warm baths or showers is a good idea.
If it's really bad, the doctor might suggest special creams or light therapy.

Important!

If someone has these symptoms, it's best to see a doctor to get the right help.