This is probably an ide reaction to a viral infection ("a flu of the skin").
There is sometimes a flu-like prodromal episode. Skin symptoms start
with a large "herald patch" or "mother patch" on trunk or arms, which
many patients can point out to you. Soon after, many smaller oval lesions
which scale at their borders appear on the trunk and (upper) arms.
Typically the lesions take on the direction of the skin lines forming a
"Christmas tree pattern" on the back. They generally cause no pain or itch
and disappear spontaneously within 2 months.
It is difficult to differentiate between pityriasis rosea and secondary
syphilis, therefore serological tests for syphilis should always be
performed.
Management of pityriasis rosea
No causal treatment is available. It is essential to explain the self-limiting nature of
the disease to the patient.
- Calamine lotion or rarely antihistamines for itch.
- Aqueous cream, emulsifying ointment or urea 10% cream for dry skin and scaling.
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