Occasionally pruritic rash
A 17-year-old woman was brought to the office by her mom because of a rash that she’d developed 3 weeks earlier. She was feeling well and the rash was only occasionally pruritic. With and without her mother in the room, the young woman denied sexual activity. Her palms and soles were spared.
What's your diagnosis?
We diagnosed pityriasis rosea by the clinical appearance, even though there was no obvious herald patch. The collarette scale was visible and the distribution was consistent with pityriasis rosea. The differential diagnosis for pityriasis rosea includes secondary syphilis and tinea versicolor.
The physician reassured the young woman and her mom that pityriasis rosea resolves spontaneously within 6 to 8 weeks. At a visit for a college physical 3 months later, her skin was clear and there was no scarring.
Photos and text for Photo Rounds Friday courtesy of Richard Usatine, MD. This case was adapted from: Henderson D, Usatine R. Pityriasis rosea. In: Usatine R, Smith M, Mayeaux EJ, Chumley H, Tysinger J, eds. The Color Atlas of Family Medicine. New York, NY: McGraw-Hill; 2009:539-544.
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