PITYRIASIS ROSEA

• Pityriais rosea is a self limiting eruption seen predominantly in adolescents and young adults. Majority of patients present with a solitary, coin sized herald patch, followed by multiple, oval, scaly papules distributed in a classic Christmas tree pattern on the trunk

• Idiopathic
• Often considered to be a viral exanthema
• Seasonal variations (more common in the spring and fall)
• Medication induced eruptions have been reported with metronidazole, captopril, penicillamine etc

• May be asymptomatic or pruritic (50% cases)
• Prodrome: 1-2 weeks prior to rash onset, flu like symptoms (malaise, fever, pharyngitis ) may be seen
• Frequently starts with herald patch (mother patch, plaque primitive, primary medallion) most commonly on the trunk followed by a disseminated eruption (trunk and proximal extremities) within several days to 2 weeks. Sometimes herald patch may be missing, or present as double or multiple lesions often close together
• Round to oval salmon colours patches following the lines of cleavage (Christmas tree like pattern) and showing peripheral attached thin cigarette paper like scales ( collarette of scaling)
• When individual lesion is stretched along the long axis, the scales tend to fold across the lines of stretch called hanging curtain sign
• Post inflammatory hypopigmentation or hyperpigmentation is seen

• Usually a clinical diagnosis

• Reassurance

Internal Medicines

• Guduchyadi kashaya
• Nimbanilavakadi kashaya
• Vilwadi gutika
• Gopeechandanadi gutika
• Avipathy choorna – in samana matra

Procedures

• Virechana – Avipathi choorna
• Gopatmajadi kera – ext application
• Yashti + Triphala choorna lepa
• Guduchyadi kashaya dhara