Tuesday, March 29, 2011

Pityriasis Rosea

Article by jekky








SymptomsThe symptoms of this condition consist of:An upper respiratory tract infection could precede all other symptoms in as a lot of as 68.8% of patientsA single, 2- to 10-cm oval red "herald" patch appears, classically on the abdomen. Occasionally, the "herald" patch may possibly happen in a 'hidden' position (in the armpit, for example) and not be noticed immediately. The "herald" patch may also appear as a cluster of smaller oval spots, and be mistaken for acne. Rarely, it does not turn into present at all.7-14 days after the herald patch, big patches of pink or red, flaky, oval-shaped rash appear on the torso. In 6% of cases an inverse distribution may happen, with rash mostly on the extremities. The more several oval patches typically spread widely across the chest initial, following the rib-line in a characteristic "christmas-tree" distribution. Small, circular patches may appear on the back and neck several days later. It is unusual for lesions to form on the face, but they could appear on the cheeks or at the hairline.About one-in-four individuals with PR suffer from mild to severe symptomatic itching. (Moderate itching due to skin over-dryness is significantly much more common, especially if soap is utilized to cleanse the affected areas.) The itching is frequently non-certain, and worsens if scratched. This tends to fade as the rash develops and does not generally last by way of the entire course of the illness.The rash may be accompanied by low-grade headache, fever, nausea and fatigue. Over-the-counter medications can aid manage these. DiagnosisHerald lesion of PR (second lesion above the ankle, approximately in the center of the plate) depicted 21 days following initial encounter. The patient had an episode of sore throat, that was treated with a strong antibiotic without success. The lesion appeared approximately one week following the end of the upper respiratory tract infection.Experienced doctors may possibly make the diagnosis clinically. If the diagnosis is in doubt, tests may possibly be performed to rule out comparable conditions such as ringworm, guttate psoriasis, nummular or discoid eczema, drug eruptions, other viral exanthems, and specifically secondary syphilis. A biopsy of the lesions will show extravasated erythrocytes inside dermal papillae and dyskeratotic cells within the dermis. TreatmentNo treatment is usually necessary.Oral antihistamines or topical steroids might be used to decrease itching. Steroids do provide relief from itching, and increase the appearance of the rash, but they also trigger the new skin that forms (right after the rash subsides) to take longer to match the surrounding skin color. Even though no scarring has been found to be associated with the rash, itching and scratching ought to be avoided. Irritants such as soap really should be avoided, too a soap containing moisturizers (such as goat's milk) may possibly be employed, even so, any generic moisturizer can support to manage over-dryness.[citation needed]Direct sunlight makes the lesions resolve much more quickly. According to this principle, medical treatment with ultraviolet light has been utilized to hasten resolution, although studies disagree whether or not it decreases itching or not. UV therapy is most beneficial in the initial week of the eruption. PrognosisIn most patients, the condition lasts only a matter of weeks in some circumstances it can last longer (up to six months). The illness resolves totally without having lengthy-term effects. Two percent of patients have recurrence. EpidemiologyThe overall prevalence of PR in the United States has been estimated to be .13% in men and .14% in females. It most commonly occurs between the ages of 10 and 35. It is far more common in winter. See alsoPityriasis circinata - a localized form of pityriasis rosea that affects the axillae and groinPityriasis - for list of similarly named flaky skin conditions References^ Freedberg et al (2003), Fitzpatrick's Dermatology in General Medicine (6th ed.), McGraw-Hill, p. 445, ISBN 0071380760 ^ James, William Berger, Timothy Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology (10th ed.). Saunders. pp. 208-9. ISBN 0721629210. ^ a b c d e f g h i j Habif, Thomas P (2004), Clinical Dermatology: A Clinical Guide to Diagnosis and Therapy (4th ed.), Mosby, pp. 246-8, ISBN -323-01319-8 ^ "Pityriasis rosea". DERMAdoctor.com. http://www.dermadoctor.com/article_Pityriasis-Rosea_60.html. Retrieved 26 Jan 2010. ^ "Pityriasis rosea". American Osteopathic College of Dermatology. http://www.aocd.org/skin/dermatologic_diseases/pityriasis_rosea.html. Retrieved 26 Jan 2010. ^ Sharma, P (2000). J Am Acad Dermatol 42 (2 pt 1): 241. ^ a b c d e f "Pityriasis rosea". American Academy of Dermatology. 2000, 2003. http://www.aad.org/public/publications/pamphlets/typical_pityriasis.html. Retrieved 2009-06-04. ^ Tay, Y Goh, C (829). "1-year review of pityriasis rosea at the National Skin Centre, Singapore". Ann Acad Med Singapore 28 (6). ^ Horn T, Kazakis A (1987). "Pityriasis rosea and the require for a serologic test for syphilis". Cutis 39: 81. ^ a b c Arndt, KA (1983). "Treatment of pityriasis rosea with UV radiation". Arch Dermatol 119: 381. ^ Leenutaphong V, Jiamton S (1995). "UVB phototherapy for pityriasis rosea: a bilateral compatison study". J Am Acad Dermatol 33 (6): 996. ^ Kempf, W et al (1999). "Pityriasis rosea is not connected with Human herpesvirus 7". Arch Dermatol 135 (9): 1070. ^ Chuang, T-Y et al (1982). "Pityriasis rosea in Rochester, Minnesota, 1969 to 1978: a 10-year epidemiologic study". J Am Acad Dermatol 7: 80.  External linksAmerican Academy of Dermatology - Pityriasis RoseaeMedicine.com - Pityriasis RoseaWebMD.com - Pityriasis RoseaHealthInPlainEnglish - Pityriasis roseaDermNet viral/pityriasis-roseahttp://www.aocd.org/skin/dermatologic_diseases/pityriasis_rosea.html Pityriasis Rosea overviewLinks to pityriasis rosea pictures (Hardin MD/Univ of Iowa)Go Ask Alice Health Assistance from Columbia UniversityAmerican Osteopathic College of Dermatologyv  d  eDiseases of the skin and appendages by morphologyGrowthsEpidermalwart  callus  seborrheic keratosis  acrochordon  molluscum contagiosum  actinic keratosis  squamous cell carcinoma  basal cell carcinoma  merkel cell carcinoma  nevus sebaceous  trichoepitheliomaPigmentedFreckles  lentigo  melasma  nevus  melanomaDermal andsubcutaneousepidermal inclusion cyst  hemangioma  dermatofibroma  keloid  lipoma  neurofibroma  xanthoma  Kaposi's sarcoma  infantile digital fibromatosis  granular cell tumor  leiomyoma  lymphangioma circumscriptum  myxoid cystRashesWithepidermalinvolvementEczematouscontact dermatitis  atopic dermatitis  seborrheic dermatitis  stasis dermatitis  lichen simplex chronicus  Darier's disease  glucagonoma syndrome  langerhans cell histiocytosis  lichen sclerosus  pemphigus foliaceus  Wiskott-Aldrich syndrome  Zinc deficiencyScalingpsoriasis  tinea (corporis  cruris  pedis  manuum  faciei)  pityriasis rosea  secondary syphillis  mycosis fungoides  systemic lupus erythematosus  pityriasis rubra pilaris  parapsoriasis  ichthyosisBlisteringherpes simplex  herpes zoster  varicella  bullous impetigo  acute contact dermatitis  pemphigus vulgaris  bullous pemphigoid  dermatitis herpetiformis  porphyria cutanea tarda  epidermolysis bullosa simplexPapularscabies  insect bite reactions  lichen planus  miliaria  keratosis pilaris  lichen spinulosus  transient acantholytic dermatosis  lichen nitidus  pityriasis lichenoides et varioliformis acutaPustularacne vulgaris  acne rosacea  folliculitis  impetigo  candidiasis  gonococcemia  dermatophyte  coccidioidomycosis  subcorneal pustular dermatosisHypopigmentedtinea versicolor  vitiligo  pityriasis alba  postinflammatory hyperpigmentation  tuberous sclerosis  idiopathic guttate hypomelanosis  leprosy  hypopigmented mycosis fungoidesWithoutepidermalinvolvementRedBlanchableErythemaGeneralizeddrug eruptions  viral exanthems  toxic erythema  systemic lupus erythematosusLocalizedcellulitis  abscess  boil  erythema nodosum  carcinoid syndrome  fixed drug eruptionSpecializedurticaria  erythema (multiforme  migrans  gyratum repens  annulare centrifugum  ab igne)NonblanchablePurpuraMacularthrombocytopenic purpura  actinic purpuraPapulardisseminated intravascular coagulation  vasculitisInduratedscleroderma/morphea  granuloma annulare  lichen sclerosis et atrophicus  necrobiosis lipoidicaMiscellaneousdisordersUlcersHairtelogen effluvium  androgenic alopecia  trichotillomania  alopecia areata  systemic lupus erythematosus  tinea capitis  loose anagen syndrome  lichen planopilaris  folliculitis decalvans  acne keloidalis nuchaeNailonychomycosis  psoriasis  paronychia  ingrown nailMucousmembraneaphthous stomatitis  oral candidiasis  lichen planus  leukoplakia  pemphigus vulgaris  mucous membrane pemphigoid  cicatricial pemphigoid  herpesvirus  coxsackievirus  syphilis  systemic histoplasmosis  squamous cell carcinomav  d  eDiseases of the skin and subcutaneous tissue (integumentary system) (L, 680-709)InfectionsBacterialskin diseaseStaphylococcus (Staphylococcal scalded skin syndrome, Impetigo, Boil, Carbuncle)  Strep (Impetigo)  Corynebacterium (Erythrasma)Viralskin diseaseWart  Molluscum contagiosum  Erythema infectiosum  Exanthema subitum  Herpes simplex (Herpetic whitlow, Eczema herpeticum)GeneralCellulitis (Paronychia)  Acute lymphadenitis  Pilonidal cyst  Pimple (Pustule)Bullousdisordersacantholysis (Pemphigus, Transient acantholytic dermatosis)  Pemphigoid (Bullous, Cicatricial, Gestational)  Dermatitis herpetiformisInflammatoryDermatitisand eczemaAtopic dermatitis  Seborrhoeic dermatitis (Dandruff, Cradle cap)  Contact dermatitis (Diaper rash, Urushiol-induced contact dermatitis)  Erythroderma  Lichen simplex chronicus/Prurigo nodularis  Itch (Pruritus ani, Pruritus scroti, Pruritus vulvae)  Nummular dermatitis  Dyshidrosis  Pityriasis albaPapulosquamousdisordersPsoriasis (Psoriatic arthritis)  Parapsoriasis (Pityriasis lichenoides et varioliformis acuta, Pityriasis lichenoides chronica, Lymphomatoid papulosis)  other pityriasis (Pityriasis rosea, Pityriasis rubra pilaris)  other lichenoid (Lichen planus, Lichen nitidus)UrticariaDermatographic urticaria  Cold urticaria  Cholinergic urticaria  Solar urticariaErythemaErythema multiforme/drug eruptionStevens-Johnson syndrome  Toxic epidermal necrolysis  Erythema nodosum   Acute generalized exanthematous pustulosisOther erythemaErythema annulare centrifugum  Erythema marginatum  Keratolytic winter erythema  Necrolytic migratory erythema  Erythema toxicumRadiation-relateddisordersSunburn  actinic rays (Actinic keratosis, Actinic cheilitis)  Polymorphous light eruption (Acne aestivalis)  Radiodermatitis  Erythema ab ignePigmentation/Dyschromiahypopigmentation (Albinism, Vitiligo)  hyperpigmentation (Melasma, Freckle, Caf au lait spot, Lentigo/Liver spot, Acanthosis nigricans, Acral acanthotic anomaly)Other skinkeratosis/hyperkeratosis (Seborrheic keratosis, Callus)  other epidermal thickening (Ichthyosis acquisita, Palmoplantar keratoderma)skin ulcer (Pyoderma gangrenosum, Bedsore)Cutaneous Markers of Internal Malignancy (Florid cutaneous papillomatosis, acanthosis nigricans, sign of Leser-Trelat)atrophic (Lichen sclerosus, Acrodermatitis chronica atrophicans)necrobiosis (Granuloma annulare, Necrobiosis lipoidica)  other granuloma (Granuloma faciale, Pyogenic granuloma)cutaneous vasculitis (Livedoid vasculitis, Erythema elevatum diutinum)Connectivetissuescollagen illness: Keloidlocalized connective tissue disorders: Lupus erythematosus (Discoid lupus erythematosus, Subacute cutaneous lupus erythematosus)  Scleroderma/Morphea  Linear scleroderma  Calcinosis cutis  Sclerodactyly  Ainhumintegument, SF, LCT navs: anat/physio, noncongen/congen/neoplasia, symptoms+signs/eponymous, proc Categories: Papulosquamous hyperkeratotic skin diseases | Ailments of unknown etiologyHidden categories: All articles with unsourced statements | Articles with unsourced statements from January 2009



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