A 14-yr-old with pityriasis rosea: a case report
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A 14-year-old female presented with a rash for 2 weeks. Initially, the rash began as a single oval scaly patch on the chest that was concerning for ringworm. The patient tried over-the-counter antifungal cream twice daily without improvement.

The following week, she developed several more similar looking but smaller lesions on her abdomen and back. The rash is mildly pruritic. On exam, round and oval pink, peripherally scaling patches and thin plaques were seen on the chest, abdomen, back, inguinal folds and axillae.

The patient was diagnosed with pityriasis rosea (PR). PR begins as a single lesion, usually on the trunk, often larger than the subsequent lesions that develop and is referred to as the “herald patch”. Within several days to weeks, patients develop many more lesions that tend to follow skin tension lines or a “Christmas tree pattern,” particularly on the back. Lesions can often be found in flexural surfaces such as the axillae and inguinal folds. The rash tends to spare the face and lower body. PR lasts on average about 6 to 8 weeks, then self-resolves but occasionally can last as long as 12 weeks. Symptoms may range from asymptomatic to severely pruritic.

Key takeaways:-
- Patient history can be key when trying to differentiate PR from other similar eruptions, particularly when patients report a “herald patch.”

- PR should be distinguished from similar rashes, especially secondary syphilis, either clinically or by serology.

- Clinicians should consider PR in the differential diagnosis of a new-onset, truncal, mildly pruritic, scaling pink eruption, especially in the fall and spring, in their pediatric patients.

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Dr. V●●●d V●●●a
Dr. V●●●d V●●●a General Medicine
Very helpful for us
Jan 30, 2019Like1