Pityriasis Rosea: Causes, Symptoms, Diagnosis and Treatment

Overview

Most of us have gone through one or more episodes of rashes or allergies. The spectrum of skin allergies or skin diseases is huge some of which are severe in nature while some are comparatively mild. One such skin condition is Pityriasis Rosea which is a relatively mild skin disease and is not directly contagious in nature. It can affect people belonging to any age group and is equally widespread in men and women. Mostly, its victims are kids, teens, and people belonging to an age group of 10-35 years including expectant mothers. 

What is Pityriasis Rosea?

It generally starts with a large, scaly patch that is a little raised and appears on your back, abdomen, or chest. It is a pink or reddish-coloured rash with a coarse border around it. This patch is called the ‘mother patch’ or ‘herald patch’. It is generally about 2-10 centimetres (approximately 1-4 inches) in size. 

After a few days or a few weeks of appearance of the herald patch, you may see scaly rashes and spots across your back, abdomen, or chest. These are called ‘daughter patches’ and often resemble the shape of a pine tree or a Christmas tree. This rash or patch can be severely itchy, particularly when it is exposed to heat or sweat. In the second stage of this condition, which is called Vesicular Pityriasis Rosea, there is an eruption of several such spots.

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What are the causes of Pityriasis Rosea?

The specific cause of this skin problem is still a mystery. There is some evidence, which indicates that it might get sparked by a viral infection or an infectious pathogen. Doctors think that some strains of the herpes virus can be the reason. However, medical experts have not been able to identify any such pathogen.

Some theories suggest that autoimmune factors can cause this skin problem. Autoimmunity is when your body’s immune system attacks healthy tissues for unspecified reasons. Age cannot be a factor as most of the people who undergo this skin condition are young and healthy. 

Symptoms of Pityriasis Rosea

1. Systemic symptoms: Most of the people having pityriasis rosea display no other symptoms, but the rash sometimes follows a few days after an upper respiratory viral infection like cold, cough, sore throat or similar infection.

2. The herald patch: Herald patch is a single plaque (oval pink or red plaque about 2 to 5 cm in diameter), which appears about 1 to 20 days before a general rash of pityriasis rosea. The herald patch has a scale trailing, like a collaret, just inside the edge of the lesion.

3. Secondary rash: After the appearance of the herald patch, a few days later, more plaques (thickened lesions) or scaly patches (flat lesions) appear on the back and chest. Some plaques may also appear on the neck, upper arms and thighs, but are not common on the scalp or face. compared to the herald patch, these secondary lesions of the pityriasis rosea tend to be smaller. They are also oval in shape with a dry surface. Like the herald patch, they may have an inner collaret of scaling. Some plaques may be annular (ring-shaped).

Pityriasis rosea plaques usually follow the relaxed skin tension lines/cleavage lines (langer lines) on both sides of your upper trunk. The rash looks like a fir tree and does not involve the scalp, face, soles or palms. While pityriasis rosea may be very itchy, in most cases, it does not itch at all.

4. Atypical pityriasis rosea: Pityriasis rosea is atypical when diagnosis becomes difficult. Atypical pityriasis rosea is diagnosed when the rash has features like multiple herald patches, absence of herald patch, atypical morphology, severe itch, etc 

How do dermatologists diagnose Pityriasis Rosea?

You should visit a dermatologist or a skin specialist if you are suffering from Pityriasis Rosea. Firstly, the doctor will enquire about your medical history. Inform your doctor if you are taking some specific medication, allergic to anything, if you are pregnant, or if you had any surgery recently. Further, keep a note of when you first noticed the patch, if there have been any changes in the symptoms, or if there is some activity that you think is aggravating the rash. These points can help your doctor in determining the duration and the severity of your condition.

Usually, experienced dermatologists can diagnose this issue by the sight of it. Still, for confirmation, you might be recommended to go through a blood test like a rapid plasma agent (RPR) to find out if you are suffering from secondary syphilis, which is similar to Pityriasis Rosea. Your doctor might also suggest a biopsy or an examination by scraping the scales. With the help of these tests, the doctor can strike out other skin problems like ringworm, eczema, and a few others.

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What are the treatment methods available for Pityriasis Rosea?

The name of this disease might sound ghastly. However, it is not that complicated, and most patients go through a smooth recovery. It often clears spontaneously. But rather than taking over-the-counter medicines, it is always better to consult a specialist. Some treatments/methods for Pityriasis Rosea are as follows:

• Oral anti-viral medicines, ointments, and lotions are prescribed depending on the longevity and seriousness of the rash
• UVB phototherapy (ultraviolet light) is used to reduce itching
• Systemic Corticosteroids Therapy is used to limit the duration
• Increased exposure to sunlight
• Moisturizer cream

In the majority of the cases, Pityriasis Rosea goes away in 8-10 weeks and it does not relapse. Also, it does not leave any scars or marks after healing.

What can be done to stay comfortable while you have Pityriasis Rosea?

While this problem has a smooth recovery, self-care can play a huge role in making you feel comfortable. Along with the treatment, here is what skin specialists suggest you should do:

• Do not indulge in strenuous activities
• Stay away from hot temperatures
• Avoid bathing in hot water, take lukewarm or cold water showers as much as possible
• Do not use harsh soaps, use oatmeal-based bath products
• Use fragrance-free soaps or body wash
• Use a fragrance-free moisturizer
• Wear loose-and cotton fitting clothes
• Avoid getting sunburnt
• Take your medication dedicatedly and seek medical attention without any delay if the rash worsens

What happens if Pityriasis Rosea is left untreated?

Any health problem when left unattended can lead to graver results and bring more complications. Similarly, if Pityriasis Rosea is not given timely medical attention, then you might experience the following:

• Acute itching
• The rash might take a longer time to recover, sometimes extend up to months (this is more common in people having dark skin)
• Even after the patches heal, there will be lasting scars 

Conclusion

There is nothing much to worry about Pityriasis Rosea. We, at Apollo Hospitals ensure the availability of the best and the latest treatment opportunities for you. Our Dermatology department has some of the most experienced and proficient doctors who are knowledgeable about the most intricate kind of skin ailments.

Frequently Asked Questions (FAQs)

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Can I get Pityriasis Rosea again?

Most of the people, once recovered, do not get this problem again. At the same time, there are rare cases where Pityriasis Rosea has recurred so there is a minuscule chance that you will get this problem again.

Are there any side-effects of this treatment?

The majority of the patients do not experience any side-effects while undergoing treatment for Pityriasis Rosea. Additionally, before initiating the treatment, the doctor will collate all the information about your current health condition and any other medications that you are taking.

How can I get rid of this rash in a shorter time?

It is vital for you to understand that this rash is going to stay for some time. Avoid taking any medicines without consulting your doctor. You can try self-care tips mentioned above, which can provide some relief until your treatment gets started.