FAMILY MEDICINE® COLUMN

By John C. Wolf, D.O.Associate Professor of Family Medicine Ohio University College of Osteopathic Medicine

DAUGHTER'S PITYRIASIS ROSEA IS COMMON SKIN AILMENT OF COLLEGE-AGED WOMEN

Question: My daughter came home from college at spring break with a rash over her chest and arms that has been very itchy. She went to the student health center at her school where the doctor diagnosed it as pityriasis rosea. What is this and are other members of the family likely to get this rash? She's had the problem now for about three weeks, and it doesn't seem to be getting much better. How long will she suffer from this?

Answer: Pityriasis rosea is a common skin disorder that afflicts females about one and one-half times as frequently as it does males. Seventy-five percent of those with this disorder are between the ages of 10 and 35, but individuals of any age can get it. Your college-aged daughter is probably close to the mean age of 23 for those with pityriasis rosea. Fortunately this problem is a benign one in that it has no serious health implications other than the rash. 

Pityriasis rosea often begins with a single oval-shaped or round area of "rash" that has fine scales near its edge and measures from one-half to four inches (one to 10 cm) across. This so-called "herald patch" can appear anywhere on the body, but most often it is on the trunk. It is called a herald patch because it precedes - or "heralds" - the development of full-blown pityriasis rosea. Within five to 10 days after the herald patch, numerous smaller oval or round lesions appear in a symmetrical pattern on the trunk and extremities. 

What I've just described is a "textbook" case of pityriasis rosea. Of course, not everyone reads the medical books before they come down with an ailment, so they don't get the story "just right." These people can have the rash of pityriasis on their lower arms, face or in other ways that are atypical for this disease. In addition, they can have blisters, bumps or hives instead of the typical pityriasis lesions. 

Some individuals have low fever, muscle aching, headache and other common symptoms of mild illness preceding the pityriasis rosea. In addition, there have been a few reported outbreaks in army barracks and college dormitories adding support to the theory that this illness is caused by an as yet unclassified type of viral infection. Consequently, there is probably a very small chance that others within your family could share your daughter's spring break malady. 

Pityriasis rosea typically takes two to 12 weeks to clear up. Some people have very intense itching with this illness, but fortunately, most do not. No medicine really speeds the healing process, although the use of prescription or non-prescription topical and oral medicines are often of help for the itching. The lesions eventually clear up, although it may take several more months for the subtle increased or decreased pigmentation at the sites of previous lesions to totally fade away. 

If this doesn't describe what your daughter is experiencing now, then I'd suggest that she see her doctor again. There are several other conditions that can initially look like early pityriasis rosea.

"Family Medicine" is a weekly column.

To submit questions, write to: John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.

Past columns are available online at http://www.FamilyMedicineNews.org.