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For further information, see CMDT Part 6-39: Pityriasis Rosea
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Essentials of Diagnosis
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Oval, fawn-colored, scaly eruption following cleavage lines of trunk
Herald patch precedes eruption by 1–2 weeks
Occasional pruritus
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General Considerations
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Common mild, acute inflammatory disease that is 50% more common in women
The eruption usually lasts 6–8 weeks and heals without scarring
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Diagnosis is made by finding one or more classic lesions
The lesions consist of oval, fawn-colored plaques up to 2 cm in diameter
The centers of the lesions have a crinkled or "cigarette paper" appearance and a collarette scale, ie, a thin bit of scale that is bound at the periphery and free in the center
Lesions follow cleavage lines on the trunk (so-called Christmas tree pattern), and the proximal portions of the extremities are often involved
Herald patch precedes eruption by 1–2 weeks
Pruritus, if present, is usually mild
Variants that affect the flexures (axillae and groin), so-called inverse pityriasis rosea, and papular variants, especially in patients with more darkly pigmented skin types, also occur
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Differential Diagnosis
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Secondary syphilis
Tinea corporis (body ringworm)
Seborrheic dermatitis
Tinea versicolor (pityriasis versicolor)
Lichen planus
Guttate or plaque psoriasis
Drug eruption
SARS-CoV-2 infection or COVID-19 vaccination
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See Table 6–2
Often requires no treatment, unless patients are symptomatic
In darker-skinned individuals, more aggressive management may be indicated because there may be dyspigmentation of the lesions
For mild to moderate cases, topical corticosteroids of medium strength (triamcinolone 0.1%) and oral antihistamines may be used if pruritus is bothersome
For severe or severely symptomatic cases, ultraviolet B treatments or a short course of prednisone
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