Pityriasis rosea

Pityriasis roseaMeans fine pink pink pityriasis scaling. It is a common skin disease seen in healthy individuals, most often in children and young adults. It manifests as an acute eruption papuloscuamoasa duration from 6-8 weeks. May show some variants and the diagnosis is important because it can signify or secondary syphilis. The disease is most common in spring and autumn in temperate zones. It is favored by warm, dry season.The disease typically begins through a solitary macule that trigger the eruption. Pink initial lesion increases in a few days to devein a spot with fine scales within well-demarcated edges. In a few weeks is a generalized exanthem. Itching is common.
The rash resolves spontaneously. Improvement of pruritus by topical steroids, oral anrihistaminice, lotions and bath oils local menthol menthol is indicated. In cases resistant to ultraviolet B phototherapy is beneficial dynamics. Low dose acyclovir reduces the duration of the eruption.Pityriasis generally resolves in 12 weeks pink. Most cases do not return, but some patients may relapse. Pink pityriasis persistent over three months is correctly classified as chronic pityriasis lichenoides. The prognosis is excellent. Patients are not considered contagious.
Pathogenesis and causes of pityriasis roseaPityriasis pink was considered to be a viral exanthem. Clinical presentation supports this concept. He was associated with upper respiratory tract infections, may run in families and close contact and have an increased incidence in immunocompromised individuals. The incidence increases in spring, and the disease seems to cause life-long immunity. Despite viral etiological considerations have not discovered any virus.
Signs and symptomsPityriasis pink is more common in women than in men. It develops mainly in children and young adults, although any age group can be affected. Most patients are between 10-35 years. The condition begins to trigger the eruption through a solitary macule. Initial lesion grows in a few days and becomes a pink stain with fine scales well demarcated in the periphery. Over the next two weeks is a generalized exanthem, although it can occur in a few hours or months. This secondary phase consists of bilateral and symmetrical appearance of patches with scales long axis oriented along the lines of cleavage. This phase tends to resolve within 6 weeks. Itching is common, easy-moderate.
Physical ExamTrigger spot is one of 2-10cm in diameter, located on the neck or trunk with fine scales. It is seen in over 50% of patients and can occur as multiple lesions with atypical localization. Secondary lesions appear on the abdomen, trunk, upper back and proximal limbs. They are described as having an appearance of cigarette paper, with the long axis oriented parallel along the lines of cleavage giving a classic Christmas tree look.
Atypical pityriasis occurs in 20% of patients. These variations can be separated into lesions or changes in their distribution. Photosensitivity may occur. Lesions may be localized to one area. One can see an inverse pityriasis. This form of damage appears on the face and distal extremities and is more common in children. Pata trigger may be the only manifestation of disease. He also described a variant in which unilateral lesions do not exceed the median line.Impaired oral hemorrhage may occur as spotty, ulcers, papulovezicule, erythematous bubbles or tiles. The incidence is less than 10%.
Diagnosis of pityriasis roseaHistological examination. Biopsy specimen is helpful in atypical cases. Show perivascular dermatitis, parakeratoza focal epidermal hyperplasia and focal sponginess. May epidermal cell exocytosis, sponginess variable acanthosis and a slight fine granular layer. There is an inflammatory infiltrate in the dermis.The differential diagnosis is made with the following conditions: stains erythema perstans, lichen planus, numulara dermatitis, pityriasis lichenoides, gutat psoriasis, seborrheic dermatitis, syphilis, tinea corporis, viral exanthema.
TreatmentTreatment is not necessary in most cases because it is self-limited pink pityriasis without sequelae. If severe itching can take measures for improvement. Patients should avoid harsh soaps, tight clothes and scratching. Mild Emolientele are helpful. Topical preparations with calamine, menthol, pramoxine, starch and colloidal oatmeal are good.Topical steroids can relieve itching. Sedative effect of antihistamines to help patients sleep better at night. Ultraviolet B therapy relieves itching within 24 hours, but increase postinflamatorie hyperpigmentation. Aciclovir shows resolution of the eruption if given early.
Prognosis
Pink is a self-limited disease pityriasis, benign that resolves without treatment in 6-12 weeks. Not cause lesions leave scars hyperpigmentation postinflamatorie though. The prognosis is excellent, the recurrence rate is 2%.