Heralds patch

Pityriasis Rosea CS-OSPE

Itchy and redness along the rib lines

What is the diagnosis? Pityriasis rosea

What is the differential diagnosis?

  1. Guttate psoriasis
  2. Tinea corporis
  3. Pityriasis versicolor

Describe? The patch is larger, redder, scalier and rounder than the later lesions, the skin lesions resemble a ‘Christmas tree’

What is the primary lesion, What is the name of the big lesion associated with this conditio? ‘Herald patch’ or ‘mother patch’.

What is the sign of improvement? Hyperpigmented patches

Investigations that may help?

  1. VDRL r\o syphilis
  2. Microscopic examination of scales to r/o tinea corporis & pityriasis versicolor.
  3. KOH (done in scaly lesion to rule out fungal infection)

How to manage this patient?

  1. Full history
  2. Examination
  3. Lab tests
  4. Education
  5. No treatment. Self -limiting
  6. Topical Steroid. (Never write steroid only!!)
  7. Calamine lotion.
  8. 1% salicylic acid in white paraffin- to reduce scaling