Pityriasis Rosea

Farinoosh Dadrass, MS and Wendy Kim, DO

What is pityriasis rosea?

Pityriasis rosea is a rash that consists of scaly spots that look like tiny, raised bumps found on the chest, stomach, back, arms, and legs. It is most common in older children and young adults.¹ The rash can be itchy, but in most cases does not itch at all. Some people have cold-like symptoms (fever, fatigue, headaches, sore throat, nausea, and joint pain) before the rash appears, or while they have the rash.²

The first sign of pityriasis rosea is usually a larger, scaly, oval lesion with a lighter center on the chest, stomach, back, upper arm, or thigh called a “herald patch.”¹ This patch is purple or red-brown in skin of color.¹ One or two weeks later, smaller versions of the herald patch appear on the body. They often start on the trunk. The rash may be confused with hives or eczema. In children, these patches or bumps are more commonly found in the groin region and underarms, and less commonly the hands and feet.¹ In children with darker skin types, the rash is more likely to occur on the face and scalp.²

Pityriasis rosea can last anywhere between a few weeks to over five months before it goes away. In patients with skin of color, it may leave behind discoloration, which should also go away with time.¹

What is the cause of pityriasis rosea?

The cause of pityriasis rosea is not fully understood.¹ It is possible that it is caused by a virus, but it is not thought to be contagious.^1,2

How do I know if I have pityriasis rosea?

Pityriasis rosea can typically be diagnosed by a dermatologist based on the appearance of the rash. Sometimes, a doctor will scrape or biopsy the skin if they need to confirm the diagnosis.¹ If you are pregnant and have pityriasis rosea, please be sure to talk to your obstetrician and dermatologist due to the risk of spontaneous abortions.²

What treatments are available for pityriasis rosea?

It is not necessary to treat pityriasis rosea as it usually goes away on its own.^1,2 Fragrance-free soaps and moisturizers, as well as anti-itch creams and over-the-counter allergy medications (antihistamines), can help with itching.^1,2 It is also recommended that any baths or showers are taken with lukewarm water. For prolonged or severe symptoms, prescription steroid cream, oral medication, and/or light therapy may be recommended as well.^1,2

Additional Resources

• https://www.aad.org/public/diseases/a-z/pityriasis-rosea-overview
• https://www.mayoclinic.org/diseases-conditions/pityriasis-rosea/symptoms-causes/syc-20376405

References

1. Schadt C. Pityriasis Rosea. JAMA Dermatol. 2018;154(12):1496. doi:10.1001/jamadermatol.2018.3290
2. Villalon-Gomez JM. Pityriasis Rosea: Diagnosis and Treatment. Am Fam Physician. 2018;97(1):38-44.