Heralds patch
Pityriasis Rosea CS-OSPE
Itchy and redness along the rib lines
What is the diagnosis? Pityriasis rosea
What is the differential diagnosis?
- Guttate psoriasis
- Tinea corporis
- Pityriasis versicolor
Describe? The skin lesions resemble a ‘Christmas tree’ pattern. The patch is larger, redder, scalier and rounder than the later lesions, and can be an annular erythematous 2-10 cm patch anywhere on the body, with peripheral scaling and central clearing.
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 pathology? Viral agent HHV-7 is implicated.
What is the sign of improvement? Hyperpigmented patches
Investigations that may help?
- VDRL r\o syphilis / to exclude syphilis.
- Microscopic examination of scales/KOH (done in scaly lesion): to r/o tinea corporis & pityriasis versicolor / to rule out fungal infection.
How to manage this patient?
- Full history, Examination, Lab tests, Education, Reassurance.
- No treatment. Self -limiting, lasts 2-10 weeks.
- For severe cases:
- Topical Steroid. (Never write steroid only!!)
- Oral antihistamines.
- Calamine lotion.
- 1% salicylic acid in white paraffin - to reduce scaling.