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
REFERENCE:
- CDC Pityriasis Rosea Image
- Pityriasis Rosea- Mayo Clinic
- Epocrates Pityriasis Rosea (paid version)
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