Evaluation of clinico-epidemiological and histopathological features of pityriasis rosea

Abstract

IntroductionPityriasis rosea is a sudden-onset and self limiting disease with specific skin rash. The exact etiology is still not clear.AimTo determine epidemiological, etiological, clinical and histopathological features in pityriasis rosea (PR).Material and methodsFifty two patients (older than 18 years) with PR were included in this study. Patients were examined for epidemiological and etiological features. Biopsy specimens obtained from secondary eruptions were histopathologically evaluated with hematoxylin-eosine and immunohistochemically evaluated with CD3 and CD20 monoclonal antibodies.ResultsAge range of patients was 18–53, mean age was 29.3 ±9.5 and women-to-men ratio was 1.08/1. Thirty-nine (75%) patients had a history of wearing new clothes, 27 (51.9%) patients had a history of recent respiratory tract infection, 15 (28.8%) patients had a history of recent gastrointestinal infection. Eczematous changes were detected in biopsy materials by histopathological evaluation, and cellular infiltrate was positively stained with pan T-cell marker CD3 and negatively stained with B lymphocyte marker CD20 in all biopsy materials in immunohistochemical examination.ConclusionsIn our study, frequency of pre-disease infection and prodromal symptoms history were determined to be higher than the results of similar studies in the literature. These higher results suggest that PR may be delayed-type hypersensitivity to an infectious factor. However, positive staining of all biopsy materials with pan T lymphocyte marker CD3 supports the association with cellular immunity. We believe that more extensive studies are needed on this issue.

Atypical Case of Pityriasis Rosea in a Child Following Streptococcal Erythema Nodosum

“…5,6 A history of preceding respiratory or gastrointestinal infection and isolation of beta-hemolytic streptococcus in throat cultures were confirmed in PR. 7…”

Pityriasis rosea

“…9 Constitutional symptoms are usually absent but a recent case series of 52 patients found prodromal symptoms (fever, headache, arthralgia, cough, vomiting, or lymphadenopathy) in 59.6%. 10 Pruritus is variable in intensity and frequency and has been reported to affect 50% of patients. 5 Topical treatments of all forms have been reported to exacerbate the pruritus.…”

Acral pityriasis rosea: A rare variant of pityriasis rosea

“…Herald patch is also pathognomonic that can be generally observed in up to 80 % of PR cases while palmoplantar herald patches were reported in a few patients. [4][5][6][7] As the appearance of palmoplantar lesions may indicate secondary syphilis, serological tests should always be investigated in virtually all suspected cases.…”