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ityriasis rosea is a most perplexing skin ailment. No one knows what causes it or what makes it disappear in a matter of weeks. We do know that it is usually a mild condition and that it is probably not contagious, even though small epidemics of the disease have occurred in Turkish baths, military establishments, and fraternity houses. If it is contagious, no one has been able to discover the germ that might be responsible.
Pityriasis rosea-like rashes can also occur in people taking various medications: penicillin, Accutane, Flagyl, barbiturates, beta-blockers, and others.
Commonly mistaken for ringworm, pityriasis rosea is a unique disorder. It usually begins as a single, large, round or oval pinkish patch, known as the “mother” or “herald” patch. The most common sites for this solitary lesion are the chest, the back, or the abdomen. This is followed in about two weeks by a blossoming of small, flat, oval, scaly patches of similar color usually distributed in a Christmas tree pattern over the chest and back.
This eruption seldom itches and usually limits itself to areas from the neck to the knees. It is more common in adolescents and young adults and in the spring and autumn. It disappears as mysteriously as it came – the older lesions fading first – in about six to eight weeks, without leaving any marks or scars and without causing any complications. It rarely crops up in the same family at the same time, it is not a sign of ill health, and it doesn’t affect the unborn children of pregnant women who are afflicted with it. And, it almost never recurs.
In other words, it’s a pretty friendly skin condition!
There are, of course, exceptions, as there are in most skin diseases. For example, the herald plaque, which is supposed to signal the coming of a batch of smaller lesions, may be neither large nor conspicuous. Also, while the normal rash, at its peak, follows the Christmas tree pattern, it may cover the entire body. Occasionally, the condition may be accompanied by fierce and uncontrollable itching and, even more rarely, by fever, malaise, loss of appetite, and swollen lymph glands in the neck.
I have seen pityriasis rosea last for over three months, and I have seen cases in the summer and winter. Several of my patients have been young children with intensely itchy “bumps” on not only the trunk but also the entire face and scalp, and I’ve even noted recurrences of this condition time and again. But, fortunately, these are only the exceptions. Usually, it is an extremely mild condition.
The treatment of pityriasis rosea is purely symptomatic: if it doesn’t itch, leave it alone. If your itching is mild, soothing baths and an over-the-counter hydrocortisone cream or lotion applied two or three times daily should give you adequate relief. However, if the itching becomes intense and the rash begins to spread very rapidly, you should consult a dermatologist. He or she will prescribe appropriate oral medication and occasionally ultraviolet light treatments to relieve the itching and shorten the course of the disease.
One bit of advice: for your own peace of mind, don’t take too much stock in nonprofessional opinions. Some people, seeing the sudden onset and spread of this strange rash, have shown it to relatives, friends, and the friendly pharmacist, who tell them that they probably have either ringworm, syphilis, AIDS, or some bizarre blood disorder. The most important consideration for those with pityriasis rosea is the reassurance that it is neither serious, contagious, infectious, nor malignant, and that it will eventually disappear in a matter of a few weeks without leaving permanent marks or scars.
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For more information on pityriasis rosea, log on to: www.aad.org 1-888-462-DERM x22 |
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| TREATING PITYRIASIS ROSEA |
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Since pityriasis rosea is usually fairly widespread, the best method of treating it is with soothing baths. For the scaling and itching that accompany it, use either:
Aveeno Baths
Or any other bath oil
Directions for use are on container.
For localized itching, apply either of the following to the affected areas 2 or 3 times daily:
Cort-Aid Cream 0.5%
Sarna Lotion
Directions for use are on the labels.
If itching persists, take either of the following antihistamines:
Chlor-Trimeton
Benadryl 25 mg
Directions for use and cautions are on the labels.
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