Pityriasis rosea: The Daily PANCE Blueprint
A teen has a single 'herald patch' on their trunk, followed 1-2 weeks later by a diffuse papulosquamous rash in a 'Christmas tree' pattern. Which of the following is the most likely diagnosis?
A. Tinea Corporis
B. Guttate Psoriasis
C. Pityriasis Rosea
D. Secondary Syphilis
E. Nummular Eczema
Answer and topic summary
The answer is E. Pityriasis rosea
Pityriasis rosea is an acute, benign, exanthematous disorder. It classically begins with a single, larger, salmon-colored oval plaque with fine scale, known as a “herald patch”. This initial lesion is followed approximately 1-2 weeks later by a generalized eruption of smaller, similar-looking papules and plaques. On the back, these lesions align along cleavage lines, creating a characteristic “Christmas tree” distribution. Diagnosis is clinical; skin biopsy is rarely necessary. Some studies have suggested that human herpesviruses could be the cause, but no research has confirmed this. Pruritus should be managed with topical corticosteroids (also lukewarm oatmeal baths may help); there is no cure or definitive treatment. Patients need to be educated that the rash won’t go away immediately, but no follow-up is necessary as long as it resolves in 2-3 months.
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Smarty PANCE Content Blueprint Review:
Covered under ⇒ PANCE Blueprint Dermatology ⇒ ⇒
