Pityriasis rosea: An update on etiopathogenesis and management of difficult aspects

Abstract

Pityriasis rosea (PR) is a benign papulosquamous disorder seen commonly in clinical practice. Despite its prevalence and benign nature, there are still times when this common disorder presents in an uncommon way or course posing diagnostic or management problems for the treating physician. The etiopathogenesis of PR has always been a dilemma, and extensive research is going on to elicit the exact cause. This review focuses mainly on the difficult aspects of this benign common disorder such as etiopathogenesis, atypical manifestations, recurrent cases, differential diagnosis, therapy and pregnancy considerations. Although we could not find a black and white solution to all these problems, we have tried to compile the related literature to draw out some conclusions.

Scabies Surrepticius: Scabies Masquerading as Pityriasis Rosea

“…The initial clinical impression of pityriasis rosea during the preliminary evaluation of our patient was prompted by not only the absence of pruritus, but also the morphology and distribution of the skin lesions on his trunk; there were numerous scaly oval plaques along Langer's lines of cleavage in a fir-tree distribution [ 4 ]. However, the closer examination led us to perform skin scrapings for a mineral oil preparation based upon the identification of the burrows on his finger webs.…”

“…Scabies is a parasitic infestation caused by the mite Sarcoptes scabiei [ 1 - 3 ]. Pityriasis rosea is a papulosquamous dermatosis that typically affects the chest, abdomen, and back [ 4 ]. A male with scabies, confirmed by the evaluation of a mineral oil preparation of the skin scrapings is described in this case, who presented with papulosquamous plaques that had a morphology and distribution resembling pityriasis rosea.…”

Recurrent pityriasis rosea: A case report

“…If a women develops pityriasis rosea during pregnancy, it may lead to serious outcomes in newborns, such as low gestational weight, stillbirth, and premature delivery. 1 Some studies have showed that the approximate incidence of pityriasis rosea is 0.5–2%, 2 and pityriasis rosea relapses in 3.7% of cases. 3 Since recurrent pityriasis rosea was first reported in detail by Halkier-Sørensen in 1990, to the best of our knowledge, only a few patients with recurrent pityriasis rosea have been described in English language journals, as determined by a Pubmed search.…”

Occult hepatitis B virus infections (often with human herpesvirus 7 co-infection) detected in pityriasis rosea patients: A pilot study

“…Hypotheses have been put forward regarding the exact cause of PR, suggesting both infective agents and noninfective etiologies such as autoimmunity and atopy. [ 3 ] However, many authors are of opinion that the distinct clinical course of PR points toward an infectious etiology. This led to the evaluation of cytomegalovirus, Epstein–Barr virus, parvovirus B19, picornavirus, influenza and parainfluenza viruses, Streptococcus spp., Legionella spp., Mycoplasma spp., and Chlamydia spp.…”