Guess That Diagnosis: Oval Rash on Trunk

Oval Round Rash


A 20 yr old female comes in to the office with complaints of a rash on her trunk. She has had the rash for 3 weeks now. She states that it started with one main patch for 2 weeks. Now she has developed several smaller round patches that have spread down her trunk. The rash is not on her face, palms, or soles of feet. She says that it is mildly pruritic and she has been taking some benadryl for that. The rash appears to spread out in a christmas tree pattern.

Guess this diagnosis.


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ANSWER

PITYRIASIS ROSEA

WHAT IS IT: A skin rash with unclear cause. Theories suggests may be viral cause for this rash

LABS/TEST: Generally diagnosis is simply from physical exam & history. Skin biopsy and or KOH or fungal cultures sometimes done to rule out other causes

S/S: Rash generally starts as a scaly oval patch on the trunk (herald’s patch) and then weeks later -smaller oval-round rashes develop. The rash is usually mildly pruritic. Rash spreads down the trunk in a Christmas tree pattern

AGE: 10-35yrs old most typical

CAUSE: is unknown, however it has been linked to viral illnesses

TREATMENT: topical corticosteroids, antihistamines for itching, topical emollients

PROGNOSIS: self-limited and usually very little treatment is needed. Usually lasts several weeks but sometimes can last up to 5 months

RECOMMENDED BOOKS

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REFERENCE:

  1. CDC Pityriasis Rosea Image
  2. Pityriasis Rosea- Mayo Clinic
  3. Epocrates Pityriasis Rosea (paid version)

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DISCLAIMER: The information posted is not intended to be medical advice. Check with your primary care provider regarding questions about your health. This post and all other posts are for educational purposes only. This information is intended for medical professionals & students. This is not intended to guide in medical decisions or treatment in any way. As always, medical professionals should call the on call provider if any clarifications are needed. State and hospital protocols should always be followed accordingly. Med Made Ez (MME) disclaims any liability for the decisions you make based on this information.

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