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Scholars around the world have dedicated themselves to developing an effective vaccine against SARS-CoV-2. However, vaccines have produced adverse effects in some patients. We report the case of a 44-year-old man who developed a pruritic papulosquamous rash on the trunk with a characteristic pattern known as Christmas tree after receiving the first dose of the Oxford-AstraZeneca COVID-19 vaccine, similar to pityriasis rosea (PR). He had no previous symptoms of viral infection and tested negative for neutralizing antibodies (enzyme immunoassay) against COVID-19. There are few reports in the literature about the relationship between the onset of cutaneous adverse reactions and the Oxford-AstraZeneca vaccine, therefore, the dissemination of this case is of paramount importance.
Subject(s)
Humans , Male , Adult , Pityriasis Rosea/diagnosis , COVID-19 Vaccines/adverse effects , ChAdOx1 nCoV-19/adverse effects , SARS-CoV-2 , COVID-19/pathologyABSTRACT
Las manifestaciones cutáneas relacionadas a la infección por el coronavirus SARS-CoV-2, causante de COVID-19, se han descrito entre el 0,2% y 20,4% de las personas que cursan con esta enfermedad. Las más frecuentemente descritas son: lesiones maculopapulares (47%), lesiones acrales eritematosas con vesículas o pústulas (pseudoperniosis) (19%), urticariales (19%), lesiones vesiculosas (9%) y livedo/necrosis (6%). En particular, la pitiriasis rosada es una dermatosis autolimitada de etiología desconocida, sin embargo, se ha visto asociada a la infección por SARS-CoV-2, con algunos reportes de casos en la literatura. El mecanismo fisiopatológico de las lesiones cutáneas en COVID-19 no es claro, y se han planteado algunas teorías, entre las cuales está el papel que juega la enzima convertidora de angiotensina 2 (ACE2) utilizada por el virus para infectar las células, los infiltrados linfocíticos, los depósitos de factores del complemento en la piel, y la reactivación de virus latentes como los herpes virus humanos. Se presenta el caso de una paciente con pitiriasis rosada asociada a COVID-19 y se describen los casos reportados hasta la fecha
Subject(s)
Humans , Pityriasis Rosea , Skin , Skin Manifestations , Urticaria , Coronavirus , Exanthema , SARS-CoV-2 , COVID-19ABSTRACT
ABSTRACT Introduction: Pityriasis rosea is an acute and self-limited exanthem first described by Gilbert in 1860. Its treatment is symptomatic, and although there is no conclusive evidence, it has been associated with the reactivation of the human herpesviruses 6 and 7 (HHV-6 and HHV-7). Case presentation: A 28-year-old woman, from Bogotá, Colombia, a health worker, attended the emergency room due to the onset of symptoms that began 20 days earlier with the appearance of punctiform lesions in the left arm that later spread to the thorax, abdomen, opposite arm, and thighs. The patient reported a history of bipolar II disorder and retinal detachment. After ruling out several infectious diseases, and due to the evolution of the symptoms, pityriasis rosea was suspected. Therefore, treatment was started with deflazacort 30mg for 21 days, obtaining a favorable outcome and improvement of symptoms after 2 months. At the time of writing this case report, the patient had not consulted for recurrence. Conclusion: Primary care physicians should have sufficient training in dermatology to recognize and treat dermatological diseases since many of them are diagnosed based on clinical findings. This is an atypical case, in which the patient did not present with some of the pathognomonic signs associated with pityriasis rosea.
RESUMEN Introducción. La pitiriasis rosada es un exantema agudo y autolimitado que fue descrito formalmente por Gilbert en 1860. Su tratamiento es sintomático y, aunque faltan pruebas concluyentes, su aparición se ha asociado a la reactivación de los herpevirus humanos 7 y 6 (HHV6 y HHV7). Presentación del caso. Mujer de 28 años procedente de Bogotá, Colombia, quien se desempeñaba como trabajadora de la salud y consultó al servicio de urgencias por un cuadro clínico de 20 días de evolución que inició con la aparición de lesiones punteadas en el brazo izquierdo que se expandieron posteriormente a tórax, abdomen, brazo contralateral y muslos. La paciente informó antecedente de trastorno bipolar tipo II y desprendimiento de retina. Después de descartar varias enfermedades infecciosas, y debido a la evolución del cuadro clínico, se sospechó pitiriasis rosada, por lo que se instauró tratamiento con 30mg de deflazacort por 21 días, con el cual se logró una evolución favorable y la mejoría total de los síntomas a los 2 meses. Hasta el momento de la elaboración del presente reporte de caso la joven no había consultado por recurrencia. Conclusión. Es indispensable que los médicos de atención primaria tengan una educación adecuada en dermatología para poder reconocer y tratar la pitiriasis rosada, pues su diagnóstico es eminentemente clínico y puede tener múltiples presentaciones atípicas, como en el caso aquí reportado donde la paciente no tuvo algunos de los signos patognomónicos característicos.
ABSTRACT
Abstract: Background: Pityriasis rosea is a common papulosquamous disorder. However, its etiology and pathogenesis remain unclear. Objective: We investigate the types of inflammatory cells infiltrating the lesional skin of pityriasis rosea and demonstrate whether T-cell-mediated immunity is involved in the pathogenesis of this condition or not. Methods: The biopsies were taken from the lesional skin of 35 cases of patients diagnosed with pityriasis rosea. The specimens were prepared in paraffin sections, then submitted to routine immunohistochemistry procedures using monoclonal antibodies directed against CD3, CD4, CD8, CD20 and CD45RO and horseradish peroxidase-labeled goat anti-human antibodies. The positive sections were determined by the ratio and staining intensity of positive inflammatory cells. Results: The mean score of positive CD3, CD4, CD8, and CD45RO staining was respectively 3.74±3.88, 5.67±4.40, 2.94±3.42 and 7.68±4.33 in these pityriasis rosea patients (P<0.001). The percentage of positive staining was 54.29% (19/35), 69.7% (23/33), 40% (14/35) and 79.41% (27/34) (P<0.05). However, the staining of CD20 was negative in all samples. The mean score of CD3 staining in patients with time for remission ≤60 days (4.90±4.21) was higher than that in patients with time for remission >60 days (2.00±2.5) (P<0.05), whereas no statistical difference in the mean score of CD4, CD8 and CD45RO staining was observed. study liMitations: The sample size and the selected monoclonal antibody are limited, so the results reflect only part of the cellular immunity in the pathogenesis of pityriasis rosea. Conclusion: Our findings support a predominantly T-cell mediated immunity in the development of pityriasis rosea.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Young Adult , T-Lymphocyte Subsets/pathology , Pityriasis Rosea/pathology , Reference Values , Staining and Labeling , Time Factors , Biopsy , Immunohistochemistry , CD4-Positive T-Lymphocytes/pathology , T-Lymphocyte Subsets/immunology , Pityriasis Rosea/immunology , Leukocyte Common Antigens/analysis , CD3 Complex/analysis , CD8-Positive T-Lymphocytes/pathology , Immunity, CellularABSTRACT
Abstract: Background: There is a lack of evidence to support acyclovir administration in pityriasis rosea. Objective: To determine the efficacy of acyclovir in patients with typical pityriasis rosea. Methods: A systematic review and meta-analysis of experimental studies was performed in MEDLINE, SCOPUS, EMBASE and others, from January 1990 to October 2016 on acyclovir for pityriasis rosea. Random effect model was used to find the pooled Risk Ratio. Outcomes, evaluated between weeks 1 to 8, were regression of lesions, cessation of lesions, decrease of symptoms and duration of disease. Comparisons were acyclovir vs. placebo; acyclovir vs. symptomatic treatment; acyclovir vs. antibiotic; acyclovir vs. observation and combined therapy (acyclovir plus symptomatic treatment) vs. symptomatic treatment alone. Results: Seven papers were analyzed with 324 participants, of which 159 received acyclovir and 165 were controls. Acyclovir was superior to placebo for complete regression of lesions at week 1 (Risk Ratio 5.72, CI95% 2.36-13.88). However, combined therapy was not superior to symptomatic treatment at week 4 (Risk Ratio 1.46, CI95% 0.93-2.29). Individual studies showed the superiority of acyclovir for the control of symptoms and pruritus. Study limitations: We faced differences designs of trials and inconsistency between reports. Conclusion: Symptomatic treatment is a reasonable option for pityriasis rosea, and the addition of acyclovir is justified for the control of symptoms and pruritus.
Subject(s)
Humans , Male , Female , Child , Adult , Antiviral Agents/therapeutic use , Acyclovir/therapeutic use , Pityriasis Rosea/drug therapy , Antiviral Agents/administration & dosage , Placebos , Acyclovir/administration & dosage , Follow-Up Studies , Administration, Topical , Treatment OutcomeABSTRACT
RESUMEN A pesar de que la Pitiriasis Rosada se considera una condición cutánea benigna, en el marco del embarazo, hay estudios que relacionan la aparición de esta patología con complicaciones asociadas en el feto. Metodología: Se realiza un reporte de caso, prospectivo, a una mujer de 36 años chilena que presentó esta patología durante la semana 12 de gestación. El objetivo fue describir, la evolución y control y contrastar su evolución con la evidencia científica actual sobre esta temática. Resultados: Paciente presenta placas eritematodescamativas concordantes con diagnóstico de pitiriasis rosada (superficie afectada menos al 50% de su cuerpo), sin presentar enantema, ni síntomas sistémicos. Tuvo un recién nacido sano a las 38 semanas de gestación, sin presentar ningún efecto adverso de los que relaciona la literatura analizada. Conclusiones: Distintos estudios han estudiado los posibles efectos adversos en el feto en madres que han presentado Pitiriasis Rosada en el embarazo, sin embargo, en este reporte de caso no se presentaron complicaciones asociadas. Faltan estudios realizados en mayor cantidad de pacientes.
ABSTRACT Although Pityriasis Rosea is considered a benign cutaneous condition, in the context of pregnancy, there are studies that relate the appearance of this pathology with associated complications in the fetus. Methodology: A prospective case report was made to a 36-year-old Chilean woman who presented this pathology during the twelve weeks of pregnancy. The objective was to describe, the evolution and control and to contrast its evolution with the current scientific evidence on this subject. Results: Patient presents concordant erythematous-desquamative plaques with diagnosis of Pityriasis Rosea (surface affected less than 50% of his body), without presenting enanthem, nor systemic symptoms. Had a healthy newborn at 38 weeks of gestation, without presenting any adverse effect related to the analyzed literature. Conclusions: Different studies have studied the possible adverse effects on the fetus in mothers who have presented pityriasis rosea in pregnancy, however in this case report there were no associated complications. Missing studies in a greater number of patients.
Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Adult , Pityriasis Rosea/complications , Pityriasis Rosea/diagnosis , Pityriasis Rosea/prevention & control , Pregnancy Complications , Pityriasis Rosea/pathology , Pityriasis Rosea/virology , Herpesvirus 6, Human/isolation & purification , Herpesvirus 7, Human/isolation & purificationABSTRACT
Comunicamos el caso de una paciente femenina de 23 años de edad, natural y procedente de la localidad, quien consulta el 30 de Noviembre de 2016 al Centro Integral de Especialidades "Los Grillitos", CORPOSALUD, Municipio Mario Briceño Iragorry, por presentar lesiones puntiformes no pruriginosas en tronco, cuya aparición fue posterior al cuadro viral leve, motivo por el que acude al médico quien le indica antihistamínicos orales y glucocorticoides tópicos no fluorados. Con posterioridad a la primera consulta médica, se evidencian lesiones ovales rosadas con relieve no pruriginoso, diseminado en tronco. Se continúa tratamiento y se indica administrar una ampolla de betametasona intramuscular. Acude nuevamente a evaluación médica y se evidencian lesiones ovales menos eritematosas, descamativas en el límite del borde libre; en general se encuentran involucionadas, observándose actualmente mejoría clínica del cuadro.
We communicate a 23-year-old female patient, natural and from the locality, who on November 30, 2016, visits the Integral Center of Specialties "Los Grillitos", CORPOSALUD, Municipality Mario Briceño Iragorry, for presenting non-pruriginous punctate lesions on the trunk, which appeared after a mild viral picture, reason why she goes to the doctor who indicates oral antihistamines and non-fluorinated topical glucocorticoids. Subsequent medical evolution shows pink oval lesions with non-pruriginous relief, disseminated in the trunk. Treatment is continued and an intramuscular betamethasone ampoule is indicated. The patient returns to medical evaluation and there is evidence of oval lesions less erythematous, desquamative at the border of the free border; in general they are involuted, observing at the moment clinical improvement of the picture.
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BACKGROUND: Pityriasis rosea (PR) is a common papulosquamous skin disease in which an infective agent may be implicated. Toll-like receptors (TLRs) play an important role in immune responses and in the pathophysiology of inflammatory skin diseases. Our aim was to determine the possible roles of TLRs 3, 7, 8, and 9 in the pathogenesis of PR. METHODS: Twenty-four PR patients and 24 healthy individuals (as controls) were included in this case control study. All recruits were subjected to routine laboratory investigations. Biopsies were obtained from one active PR lesion and from healthy skin of controls for the detection of TLR 3, 7, 8, and 9 gene expression using real-time polymerase chain reaction. RESULTS: This study included 24 patients (8 females and 16 males) with active PR lesions, with a mean age of 28.62 years. Twenty four healthy age- and sex-matched individuals were included as controls (8 females and 16 males, with a mean age of 30.83 years). The results of the routine laboratory tests revealed no significant differences between both groups. Significantly elevated expression of all studied TLRs were detected in PR patients relative to healthy controls (p < .001). CONCLUSIONS: TLRs 3, 7, 8, and 9 might be involved in the pathogenesis of PR.
ABSTRACT
Background: Acyclovir is considered to be an effective treatment for pityriasis rosea but randomized, blinded, placebo-controlled trials have not been performed. Aims: To test the efficacy of acyclovir in pityriasis rosea in a randomized, triple–blind, placebo-controlled trial. Methods: Twenty seven patients with pityriasis rosea were randomly allocated to receive placebo (n = 13) or acyclovir (800 mg fi ve times daily for one week) (n = 14). The severity of disease was assessed by the pityriasis rosea area and severity index. Cure was defi ned as the absence of erythema, with no or minimal scaling. Results: The number of days (mean ± standard deviation) taken for cure was not signifi cantly different between the two groups (placebo 26.54 ± 9.14 days versus acyclovir 33.29 ± 9.49 days; P = 0.0720, t-test; 95% confi dence interval of difference −0.65 to 14.14 days). Limitations: The sample size for the present study was calculated using data from an earlier study. As the standard deviation was not mentioned in that article, a common standard deviation of fi fteen days was assumed. A study with a larger sample size may be more effective in detecting minor treatment differences between acyclovir and placebo, if they exist at all. Conclusion: Acyclovir is not an effective treatment for pityriasis rosea.
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Objective To observe the clinical efficacy of desloratadine citrate disodium tablets combined with narrow band ultraviolet B in the treatment of pityriasis rosea.Methods According to the digital table,88 pityriasis rosea patients were randomly divided into the two groups.45 cases of the study group were treated by desloratadine citrate disodium tablets combined with narrow ultraviolet B,43 cases of the control group were treated by desloratadine citrate disodium tablets alone.The both two groups applied Binghuangfule cream.The therapeutic effect and safety of the two groups were compared.Results The cure rate in study group was 71.11％,which of the control group was 51.16％,the difference was not statistically significant (x2 =3.69,P ＞ 0.05).The effective rate of the treatment group was 91.11％,which of the control group was 69.77％,the difference between the two groups was statistically significant (x2 =6.43,P ＜ 0.05).Conclusion The result reveals that desloratadine citrate disodium tablets combined with narrow band ultraviolet B is more effective and worthy to be used in clinical practice.
ABSTRACT
Background: Macrolides are prescribed in the treatment of pityriasis rosea despite conflicting results of the limited number of studies evaluating their role in its treatment. Aim: A randomized double-blind placebo-controlled trial was conducted to evaluate the effect of azithromycin on the clinical course of pityriasis rosea. Methods: Seventy patients of pityriasis rosea were given either azithromycin (n = 35) or placebo (n = 35) and were followed-up at 2, 4 and 6 weeks. Pruritus was assessed in both groups using the visual analogue scale (VAS) . Change in the pityriasis rosea severity score (PRSS) and in the VAS were recorded as outcome measures and were compared statistically. Results: The decrease in PRSS from baseline through 2, 4 and 6 weeks within both treatment (P < 0.001) and placebo (P < 0.001) arms was found to be statistically significant; however, this change was not significantly different in the two groups (P = 0.179). Similarly, the decrease in VAS was found to be statistically significant within both groups (P < 0.001); however, the change was comparable between the two groups (P < 0.937). Analysis by Fisher's exact test did not find a significant difference between the two groups for PRSS and VAS. Conclusion: Azithromycin is not effective in pityriasis rosea and the use of macrolides for this disease should not be encouraged in clinical practice.
Subject(s)
Azithromycin/administration & dosage , Callosities/surgery , Humans , Minimally Invasive Surgical Procedures/methods , Pityriasis Rosea , Severity of Illness Index , Visual Analog ScaleABSTRACT
Background: Macrolides are prescribed in the treatment of pityriasis rosea despite conflicting results of the limited number of studies evaluating their role in its treatment. Aim: A randomized double-blind placebo-controlled trial was conducted to evaluate the effect of azithromycin on the clinical course of pityriasis rosea. Methods: Seventy patients of pityriasis rosea were given either azithromycin (n = 35) or placebo (n = 35) and were followed-up at 2, 4 and 6 weeks. Pruritus was assessed in both groups using the visual analogue scale (VAS) . Change in the pityriasis rosea severity score (PRSS) and in the VAS were recorded as outcome measures and were compared statistically. Results: The decrease in PRSS from baseline through 2, 4 and 6 weeks within both treatment (P < 0.001) and placebo (P < 0.001) arms was found to be statistically significant; however, this change was not significantly different in the two groups (P = 0.179). Similarly, the decrease in VAS was found to be statistically significant within both groups (P < 0.001); however, the change was comparable between the two groups (P < 0.937). Analysis by Fisher's exact test did not find a significant difference between the two groups for PRSS and VAS. Conclusion: Azithromycin is not effective in pityriasis rosea and the use of macrolides for this disease should not be encouraged in clinical practice.
Subject(s)
Azithromycin/administration & dosage , Azithromycin/therapeutic use , Double-Blind Method , Female , Humans , Male , Pityriasis Rosea/drug therapy , Placebos , Severity of Illness Index , Visual Analog ScaleABSTRACT
Objective To investigate the role of interleukin-22 (IL-22) in the pathogenesis of pityriasis rosea (PR).Methods Peripheral venous blood samples were obtained from 48 patients with PR in acute stage and recovery stage and from 20 healthy human controls.Real-time fluorescence-based quantitative PCR was performed to measure the mRNA expression of IL-22 in peripheral blood mononuclear cells (PBMCs),and enzyme-linked immunosorbent assay (ELISA) to determine the level of IL-22 in sera.Results The relative expression level of IL-22 mRNA in the patients with PR in recovery stage was significantly higher than that in the healthy controls (2.89 ±0.91 vs.1.91 ± 0.60,t =3.84,P ＜ 0.05),but lower than that in the patients in acute stage (2.89 ± 0.91 vs.4.15 ±1.36,t =3.61,P ＜ 0.05).Similarly,the level of serum IL-22 was significantly increased in the patients with PR in recovery stage compared with the healthy controls ((21.44 ± 7.33) vs.(13.22 ± 4.26) ng/L,t =4.49,P ＜ 0.05),and increased in the patients with PR in acute stage compared with those in recovery stage ((36.87 ± 10.63) vs.(21.44 ± 7.33) ng/L,t =5.01,P ＜ 0.05).The level of serum IL-22 was positively correlated with the stage of PR (r =0.883,P ＜ 0.05).Conclusions IL-22 is overexpressed in PBMCs and sera of patients with PR,implying that IL-22 is involved in the pathogenesis of PR.
ABSTRACT
Pityriasis rosea, first described by Gilbert in 1860, is a fairly common dermatosis. The exact cause of pityriasis rosea is not known. The earliest clinical finding of a typical case is a herald patch, which is usually on the trunk, and scaly and erythematous daughter macules, which is distributed along the skin cleavage line, such as the 'Christmas tree pattern'. This may be accompanied by Itching. Atypical cases of pityriasis rosea, such as palmoplantar, unilateral, vesicular and inverse forms, have also been reported. There is no difference between typical and atypical cases regarding the presence of a herald patch and/or symptoms. Differences between typical and atypical cases lie in the distribution of skin lesions and the characteristics of daughter macules. Hands and feet, including palms and soles, are rarely involved in pityriasis rosea. Moreover, there are no reported pathologic findings of pityriasis rosea of the palms and soles, even in atypical distributed pityriasis rosea case reports. Here, we report atypical case of pityriasis rosea with palmoplantar involvement with pathologic reports.
Subject(s)
Foot , Hand , Nuclear Family , Pityriasis , Pityriasis Rosea , Pruritus , Skin , Skin DiseasesABSTRACT
Imatinib mesylate (Gleevec(TM), STI571), a selective inhibitor of BCR-ABL, c-Kit, and platelet-derived factor receptor, has been used to treat chronic myelogenous leukemia (CML) and gastrointestinal stromal tumors. Although its use has been associated with various adverse cutaneous reactions, pityriasis rosea-like drug eruptions are rare. Here, we report a case of pityriasis rosea-like drug eruption that developed following the administration of imatinib mesylate to treat CML.
Subject(s)
Benzamides , Drug Eruptions , Gastrointestinal Stromal Tumors , Leukemia, Myelogenous, Chronic, BCR-ABL Positive , Mesylates , Piperazines , Pityriasis , Pityriasis Rosea , Pyrimidines , Imatinib MesylateABSTRACT
BACKGROUND: Pityriasis rosea is an acute inflammatory dermatosis with an unproven etiology. The typical clinical feature consists of an initial, single herald patch followed by the development of smaller, disseminated, papulosquamous and ovoid macules. OBJECTIVE: The aim of this study was to evaluate the clinical manifestations of pityriasis rosea. METHODS: We examined a total of 101 patients with pityriasis rosea who visited the Department of Dermatology in Chung-Ang University Medical Center from March of 2005 to February of 2010. RESULTS: There were 1.53 times more women (61 patients) than men (40 patients) among the study subjects. The age of onset varied from 4 years to 71 years with a mean age of 28.7 years and 60% of the cases were 20 years to 39 years old. The percentage of seasonal variation was 34% in winter, 24% in summer, 22% in spring and 21% in autumn. A herald patch was found in 43% and the main predilection sites were the trunk and the thigh. Secondary eruptions could be classified into the macular type (67%), papular type (30%), urticarial type (2%) and purpuric type (1%). They appeared on the back, the chest, the abdomen, the upper arms, the thighs, the neck, the forearm, the lower legs, the face, the hands and the feet. The histopathological findings of all the types of lesions were focal parakeratosis, intraepidermal vesicles and papillary dermal edema. As compared to the macular type, hyperkeratosis, parakeratosis and exocytosis of lymphocytes were less commonly observed in the papular type. CONCLUSION: Most of the study results were compatible with those of other previous studies. However, the number of patients with papular type pityriasis rosea was currently increasing.
Subject(s)
Female , Humans , Male , Abdomen , Academic Medical Centers , Age of Onset , Arm , Dermatology , Edema , Exocytosis , Foot , Forearm , Hand , Leg , Lymphocytes , Neck , Parakeratosis , Pityriasis , Pityriasis Rosea , Seasons , Skin Diseases , Thigh , ThoraxABSTRACT
BACKGROUND: Pityriasis rosea is an acute inflammatory dermatosis with an unproven etiology. The typical clinical feature consists of an initial, single herald patch followed by the development of smaller, disseminated, papulosquamous and ovoid macules. OBJECTIVE: The aim of this study was to evaluate the clinical manifestations of pityriasis rosea. METHODS: We examined a total of 101 patients with pityriasis rosea who visited the Department of Dermatology in Chung-Ang University Medical Center from March of 2005 to February of 2010. RESULTS: There were 1.53 times more women (61 patients) than men (40 patients) among the study subjects. The age of onset varied from 4 years to 71 years with a mean age of 28.7 years and 60% of the cases were 20 years to 39 years old. The percentage of seasonal variation was 34% in winter, 24% in summer, 22% in spring and 21% in autumn. A herald patch was found in 43% and the main predilection sites were the trunk and the thigh. Secondary eruptions could be classified into the macular type (67%), papular type (30%), urticarial type (2%) and purpuric type (1%). They appeared on the back, the chest, the abdomen, the upper arms, the thighs, the neck, the forearm, the lower legs, the face, the hands and the feet. The histopathological findings of all the types of lesions were focal parakeratosis, intraepidermal vesicles and papillary dermal edema. As compared to the macular type, hyperkeratosis, parakeratosis and exocytosis of lymphocytes were less commonly observed in the papular type. CONCLUSION: Most of the study results were compatible with those of other previous studies. However, the number of patients with papular type pityriasis rosea was currently increasing.
Subject(s)
Female , Humans , Male , Abdomen , Academic Medical Centers , Age of Onset , Arm , Dermatology , Edema , Exocytosis , Foot , Forearm , Hand , Leg , Lymphocytes , Neck , Parakeratosis , Pityriasis , Pityriasis Rosea , Seasons , Skin Diseases , Thigh , ThoraxABSTRACT
BACKGROUND: UVA1 phototherapy has recently demonstrated high levels of efficacy and tolerability for treating a variety of inflammatory and neoplastic skin diseases. OBJECTIVE: The purpose of the present study was to assess the clinical efficacy of UVA1 (340~400 nm) phototherapy for treating pityriasis rosea and to assess the course of the disease after treatment. METHODS: Fifteen patients with extensive pityriasis rosea were treated with low-dose UVA1 phototherapy (starting at 10~20 J/cm2 and then it was increased to 30 J/cm2). The treatments were given 2~3 times a week until complete clearance of lesions was achieved or until there was partial improvement without further amelioration, in spite of 5 additional treatments. The rate of clearing was monitored by estimating the pityriasis rosea severity (PRSS) score and the pruritus score. RESULTS: The extent of disease (PRSS) in all 15 patients lessened during the study (30.1+/-3.6 vs. 2.0+/-1.6, respectively, p<0.05). The overall reduction of the PRSS showed a significant improvement after the second or third treatment. The pruritus of 12 of 15 patients lessened during the treatment period, and it was unchanged in the remaining 3 patients. The mean previous duration of disease was 11.2+/-4.9 days and this did not interfere with the successful outcome of UVA1 phototherapy. CONCLUSION: This study shows that UVA1 phototherapy is a useful, well-tolerated treatment option for patients suffering from pityriasis rosea with extensive eruptions and considerable pruritus.