Atypical pityriasis rosea: a case report and a review of literature

Autor

  • Iqbal A. Bukhari University of dammam, Saudi Arabia
  • Suzan AlKhater University of Dammam and King Fahd Hospital of the University Al Khobar 31952, Saudi Arabia, Saudi Arabia

DOI:

https://doi.org/10.15587/2313-8416.2015.37943

Słowa kluczowe:

pityriasis rosea, erythema multiforme, papulosquamous eruption, herald patch, purpura

Abstrakt

Aim: Pityriasis rosea (PR) is a common acute inflammatory skin disease characterized by pruritic erythematous papulosquamous eruption that is self-limited which can rarely pose a diagnostic challenge. In this report, we present a rare presentation of PR.

Method: the case was completely evaluated including laboratory works and a final diagnosis of erythema multiforme-like PR was reached. Besides, we reviewed all atypical presentations of PR that are reported in the medical literature.

Results: our patient has a morphological variant of PR which is erythema multiforme-like. The presence of a herald patch and  the rapid resolution of the symptoms supports our diagnosis. This variant is considered rare and to our knowledge, this is the seventh case of erythema multiforme-like PR reported in the medical literature.

In conclusion: we report a case of erythema multiforme-like PR. It is important that physicians recognize the wide spectrum of PR variants so that appropriate management can be arranged. 

Biogramy autorów

Iqbal A. Bukhari, University of dammam

Professor

 

Scopus profile: link

Professional (scientific) interests: dermatology 

 

Selected Publications:

1. Al-Nutaifi, K., Bukhari, I. (2010). Overgrowth of dermatofibroma induced by strong topical steroid use. Journal of Chinese Clinical Medicine, 5 (5), 308–309.

2. Bukhari, I., Alberiki, S. (2009). Post vaccination localized morphea. Journal of Chinese Clinical Medicine, 4 (10), 599–600.

3. Bukhari, I. (2009). Off label uses of Topical Pimecrolimus. Journal of the American Osteopathic College of Dermatology, 14 (1), 11–12.

4. Alakloby, O. M., Alzahrani, A. J., Obeid, O. E., Al-Jabre, S. H., Bukhari, I. A., Taha, A. (2009). Seroprevalence of Herpes Simplex Virus in Dermatology Patients. Journal of Saudi society of Dermatologiy and Dermatologic Surgery, 13 (2), 30–35.

5. Bukhari, I. (2009). Brief Communication: Clinical patterns of cutaneous tuberculosis at the Dermatology Department of King Fahad Hospital of the University in Alkhobar, Saudi Arabia during thirteen years period (1995-2007). Saudi Medical Journal, 30 (4), 577–579.

6. Bukhari, I., Faraidy, N. (2009). New pigmented papules on the forearm of adult. Dermatololgy Online Journal, 15 (2), 10.

7. Bukhari, I. (2007). Response letter for the article entitled: Treatment of halo nevus with 308-nm excimer laser. Jouranl of Cosmetic and Laser Therapy, 9, 245–248.


Suzan AlKhater, University of Dammam and King Fahd Hospital of the University Al Khobar 31952, Saudi Arabia

MD

Department of Pediatrics

College of Medicine

Bibliografia

Chuh, A. A. T., Lee, A., Molinari, N. (2003). Case Clustering in Pityriasis Rosea. Archives of Dermatology, 139 (4), 489–493. doi: 10.1001/archderm.139.4.489

Chuh, A., Molinari, N., Sciallis, G., Harman, M., Akdeniz, S., Nanda, A. (2005). Temporal case clustering in pityriasis rosea: a regression analysis on 1379 patients in Minnesota, Kuwait and Diyarbakir, Turkey. Archives of Dermatology, 141 (6), 767–771. doi: 10.1001/archderm.141.6.767

Messenger, A. G., Knox, E. G., Summerly, R., Muston, H. L., Ilderton, E. (1982). Case clustering in pityriasis rosea: support for role of an infective agent. BMJ, 284 (6313), 371–373. doi: 10.1136/bmj.284.6313.371

Watanabe, T., Kawamura, T., Jacob, S. E., Aquilino, E. A., Orenstein, J. M., Black, J. B., Blauvelt, A. (2002). Pityriasis Rosea is Associated with Systemic Active Infection with Both Human Herpesvirus-7 and Human Herpesvirus-6. Journal of Investigative Dermatology, 119 (4), 793–797. doi: 10.1046/j.1523-1747.2002.00200.x

Gonzalez, L. M., Allen, R., Janniger, C. K., Schwartz, R. A. (2005). Pityriasis rosea: An important papulosquamous disorder. International Journal of Dermatology, 44 (9), 757–764. doi: 10.1111/j.1365-4632.2005.02635.x

Tay, Y. K., Goh, C. L. (1999). One year review of pityriasis rosea at the National Skin Centre, Singapore. Ann Acad Med Singapore, 28, 829–831.

Chuh, A., Zawar, V., Lee, A. (2005). Atypical presentations of pityriasis rosea: case presentations. Journal of the European Academy of Dermatology and Venereology, 19 (1), 120–126. doi: 10.1111/j.1468-3083.2004.01105.x

Bari, M. (1990). Purpuric Vesicular Eruption in a 7-Year-Old Girl. Archives of Dermatology, 126 (11), 1497. doi: 10.1001/archderm.1990.01670350111020

Anderson, C. R. (1971). Dapsone treatment in a case of vesicular pityriasis rosea. The Lancet, 298 (7722), 493. doi:10.1016/s0140-6736(71)92662-6

Verbov, J. (1980). Purpuric Pityriasis Rosea. Dermatology, 160 (2), 142–144. doi: 10.1159/000250488

Klauder, J. V. (1924). Pityriasis rosea with particular reference to its unusual manifestations. Journal of the American Medical Association, 82, 178–183. doi: 10.1001/jama.1924.02650290008002

Pierson, J. C., Dijkstra, J. W. E., Elston, D. M. (1993). Purpuric pityriasis rosea. Journal of the American Academy of Dermatology, 28 (6), 1021. doi: 10.1016/s0190-9622(08)80661-5

Verbov, J. (1980). Purpuric Pityriasis Rosea. Dermatology, 160 (2), 142–144. doi: 10.1159/000250488

Bernardin, R. M., Ritter, S. E., Murchland, M. R. (2002). Papular pityriasis rosea. Cutis, 70, 51–55.

Vano-Galvan, S., Ma, D.-L., Lopez-Neyra, A., Perez, B., Muñoz-Zato, E., Jaén, P. (2009). Atypical Pityriasis rosea in a black child: a case report. Cases Journal, 2 (1), 6796. doi: 10.1186/1757-1626-2-6796

Bukhari, I. (2005). Pityriasis rosea with palmoplantar plaque lesions. Dermatol Online Journal, 11, 27.

Pringle, J. J. (1915). Case presentation, section on dermatology, Royal Societyof Medicine. British Journal of Dermatology, 27, 309.

Truhan, A. P. (1984). Pityriasis rosea. Am Fam Physician, 29, 193–196.

Relhan, V., Sinha, S., Garg, V., Khurana, N. (2013). Pityriasis rosea with erythema multiforme – like lesions: An observational analysis. Indian Journal of Dermatology, 58 (3), 242. doi: 10.4103/0019-5154.110855

Gibney, M. D., Leonardi, C. L. (1997). Acute papulosquamous eruption of the extremities demonstrating an isomorphic response. Inverse pityriasis rosea (PR). Archives of Dermatology, 133 (5), 651–654. doi: 10.1001/archderm.133.5.651

Little, E. E. (1914). Discussion on pityriasis rosea. British Journal of Dermatology, 26, 329.

Fox, C. (1906). Pityriasis rosea with vesiculation. British Journal of Dermatology, 18, 281.

Vidimos, A. T., Camisa, C. (1992). Tongue and cheek: oral lesions in pityriasis rosea. Cutis, 50, 276–280.

Eslick, G. D. (2002). Atypical pityriasis rosea or psoriasis guttata? Early examination is the key to a correct diagnosis. International Journal of Dermatology, 41 (11), 788–791. doi: 10.1046/j.1365-4362.2002.01627.x

Ghersetich, I., Rindi, L., Teofoli, P. et al. (1990). Pityriasis rosea-like skin eruptions caused by captopril. G Ital Dermatol Venereol, 125, 457–459.

Bonnetblanc, J. M. (1996). Cutaneous reactions to gold salts. Presse Med, 25, 1555–1558.

Helfman, R. J., Brickman, M., Fahey, J. (1984). Isotretinoin dermatitis simulating acute pityriasis rosea. Cutis, 33, 297–300.

Yosipovitch, G., Kuperman, O., Livni, E. et al. (1993). Pityriasis rosea-likeeruption after anti-inflammatory and antipyretic medication. Harefuah, 124, 198–200.

Buckley, C. (1996). Pityriasis rosea-like eruption in a patient receiving omeprazolc syndrome. British Journal of Dermatology, 135 (4), 660–661. doi: 10.1111/j.1365-2133.1996.tb03863.x

Gupta, A. K., Lynde, C. W., Lauzon, G. J. et al. (1998). Cutaneous adverse effects associated with terbinafine therapy: 10 case reports and a review of the literature. British Journal of Dermatology, 138 (3), 529–532. doi: 10.1046/j.1365-2133.1998.02140.x

Konstantopoulos, K., Papadogianni, A., Dimopoulou, M., Kourelis, C., Meletis, J. (2002). Pityriasis rosea Associated with Imatinib (STI571, Gleevec). Dermatology, 205 (2), 172–173. doi: 10.1159/000063900

Weedon, D. (1998). Skin pathology.. New York, NY: Churchill Livingstone, 96–97.

Imamura, S., Ozaki, M., Oguchi, M., Okamoto, H., Horiguchi, Y. (1985). Atypical Pityriasis rosea. Dermatology, 171 (6), 474–477. doi: 10.1159/000249476

Okamoto, H., Imamura, S., Aoshima, T., Komura, J., Ofuji, S. (1982). Dyskeratotic degeneration of epidermal cells in pityriasis rosea: light and electron microscopic studies. British Journal of Dermatology, 107 (2), 189–194. doi: 10.1111/j.1365-2133.1982.tb00337.x

Sharma, P., Yadav, T., Gautam, R., Taneja, N., Satyanarayana, L. (2000). Erythromycin in pityriasis rosea: A double-blind, placebo-controlled clinical trial. Journal of the American Academy of Dermatology, 42 (2), 241–244. doi: 10.1016/s0190-9622(00)90132-4

Leenutaphong, V., Jiamton, S. (1995). UVB phototherapy for pityriasis rosea: A bilateral comparison study. Journal of the American Academy of Dermatology, 33 (6), 996–999. doi: 10.1016/0190-9622(95)90293-7

Drago, F., Vecchio, F., Rebora, A. (2006). Use of high-dose acyclovir in pityriasis rosea. Journal of the American Academy of Dermatology, 54 (1), 82–85. doi: 10.1016/j.jaad.2005.06.042

Ganguly, S. (2014). A Randomized, Double-blind, Placebo-Controlled Study of Efficacy of Oral Acyclovir in the Treatment of Pityriasis Rosea. Journal of clinical and diagnostic research, 8 (5), YC01–YC04. doi: 10.7860/jcdr/2014/8140.4360

Anderson, C. R. (1971). Dapsone treatment in a case of vesicular pityriasis rosea. The Lancet, 298 (7722), 493. doi: 10.1016/s0140-6736(71)92662-6

##submission.downloads##

Opublikowane

2015-02-26

Numer

Tom 2 Nr 4(7) (2015)

Dział

Medical

Licencja

Copyright (c) 2015 Iqbal A. Bukhari, Suzan AlKhater

Creative Commons License

Utwór dostępny jest na licencji Creative Commons Uznanie autorstwa 4.0 Międzynarodowe.

Our journal abides by the Creative Commons CC BY copyright rights and permissions for open access journals.

Authors, who are published in this journal, agree to the following conditions:

1. The authors reserve the right to authorship of the work and pass the first publication right of this work to the journal under the terms of a Creative Commons CC BY, which allows others to freely distribute the published research with the obligatory reference to the authors of the original work and the first publication of the work in this journal.

 2. The authors have the right to conclude separate supplement agreements that relate to non-exclusive work distribution in the form in which it has been published by the journal (for example, to upload the work to the online storage of the journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this journal is included.