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Acne Control (Home) > Rosacea > Pityriasis Rosacea Pityriasis Rosacea: Causes, Symptoms, and Treatment |
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Pityriasis rosacea is also known as PR and is referred to as a characteristics as well as acute examthem which have been introduced for more than 2 centuries. The starting is the formation of a primary plaque known as herald patch. Then it is continued by distinguishable and generalized rash which develops after 1 or 2 weeks. This remains for almost 2-6 weeks.
Before the lesions are seen, almost one week or more before the onset of the eruption of the lesions primary plague conquers almost 50-90% of patient's skin. Later the second eruption occurs after 2-21 days along the lines of the skin cleavage. A Christmas tree patch is made on the back.
It is seen frequently in the United States and is calculated to be 0.13% in men and 0.14% in women. In other countries, Uganda stands out to be a major spot. Other countries such as United Kingdom, Sudan, Nigeria, Lagos, Hong Kong, Kuwait, Singapore, Brazil and Turkey are also considered as preys.
It is proved to occur in both sexes equally and sometimes it is seen more in females. The ratio of men to women is regarded as 1:1.43. Pityriasis rosacea is commonly seen in children and young adults. It is commonly seen in persons from 15-40 years of age and is rarely seen in infants and elderly persons. But reports are available for proving that it has been found in infants of 3 months age even though it is very rare.
There are a variety of causes for pityriasis rosacea. The microorganisms such as virus, fungus and bacteria are not referred to as the causative agents but, HHV-6 and HH-7 might be considered to play a major role. Certain drugs also could be regarded as a major cause of pityriasis rosacea which includes salvarsan, bismuth, ketotifen, captopril, tripelennamine hydrochloride, gold, D-penicillamine isotretinoin, organic mercurials, metronisazole and methoxypromazine. Such a pityriasis rosacea is denoted especially as drug induced pityriasis rosacea. Other agents that are found in pityriasis rosacea patients are atopy, seborrheic dermatitis, dandruff and acne vulgaris.
Pityriasis rosacea is concerned with prodromal symptoms such as malaise, joint pain, anorexia, lymph node swelling, nausea and head ache. All these are known to be followed by the herald patch which is considered as the primary lesion. In 75% of the patients suffering from pityriasis rosacea, an intense condition known as pruritus is considered. It is always recommended to know about the occurrence of the disease.
The herald patch seen as the primary lesion measures 1-2 cm in diameter which is characterized by its appearance. It has a round or oval shape with wrinkled and central area which is salmon coloured along with a peripheral zone which is dark red in colour. A collarette of fine scales separated the area. Usually these patches are visible on the trunk even though they are seen on the neck or the extremities.
Secondary eruption follows the herald patches within ten days time. It is localized and symmetric confined to the trunks and the near about areas along the extremities and the neck. It is vastly seen over the abdomen, anterior and dorsal surfaces of the thorax. In miniature, secondary lesions occur as a primary patch in which the scaling ring is separated with two red zones. At last the patch appears to be in the shape of a Christmas tree on the back. The popular pityriasis rosacea is seen in similar pattern in children below the age of 5.
Almost 20% of patients exhibit atypical pityriasis rosacea in which the herald patches could be missing or is seen as confluent with other lesions. In children, the rash is seen in facial and peripheral areas in the skin. In some cases groin and axilla are also involved. The lesions seen are much larger known as pityriasis rosacea gigantean, pityriasis rosacea urticata where the lesions are urticarial and vesicular, pustular, purpuric and even in the form of erythema multiform. The inflammation stage is then followed by hypo pigmentary and hyper pigmentary changes in the skin. Hyper pigmentation is commonly seen in pityriasis rosacea patients having darker skin colour. Even oral lesions are reported such as ulcers, erythematous plaques and even hemorrhagic puncta.
The diagnosis is pretty tough in the case of pityriasis rosacea as diagnostic blood test is not available. Even though laboratory diagnosis is of no use, a rapid plasma regain test which is also known as RPR should be done. This is not reliable as pityriasis rosacea could also be perplexed for secondary syphilis. In pityriasis rosacea, blood profiles are usually seen to be normal even though neutrophilia, basophilia, leucocytosis and lymphocytosis are observed. ESR, total albumin, protein, alpha1 globulin and alpha2-globulin are tested and a minimal increase has been noted. Tests for rheumatoid factor which is also known as RF factor, cryoglobulins and cold agglutinins are proven to be normal.
A reliable procedure is skin biopsy which could diagnose pityriasis rosacea. Various features that help in diagnosing pityriasis rosacea are many. The absence or reduction of granular cell layer, finding of multinucleated giant cells and patchy keratosis in the tested skin, presence of spongiosis and acanthosis and papillae and epidermis shows extra vasated red blood cells. Testing a clinical dry lesion would suggest microscopic vesicles in it.
Pityriasis rosacea is considered as a self limiting condition and in majority of cases treatment is not opted for. But in people with pityriasis rosacea for more than two years, administration of erythromycin yielded best results. Certain limitations are referred to be useful for preventing pityriasis rosacea in the earlier stages. It is recommended to keep away from sweat, soap and water as it might cause more irritation. For dealing with pruritus, calamine lotion and topical zinc oxide is highly recommended and is proved to be very useful. For severe and widespread disease oral or topical steroids are preferred. Another remarkable treatment is given by ultraviolet radiation therapy which is proved to be very useful in fighting pityriasis rosacea even though it leaves back post inflammatory pigmentations at the same site.
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VISITOR COMMENTS on "Pityriasis Rosacea: Causes, Symptoms, and Treatment":
| Itchy said, | 27th March 07 |
| I was just diagnosed with PR today. I thought it was a small rash from stress or chicken pox, or something. I had no idea and had never heard of this disease. It scares me that it could be a secondary form of syphilis. It started with the herold patch (which I thought was a ring worm or some kind of bacterial infection). It got progressively worse so I went to the doctor. I start my steroids tomorrow, we'll see if that helps any. I'm soooooo itchy and very miserable. Thanks for the helpful calamine and zinc oxide suggestions, I'll try anything! | |
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