Skip to Main Content

Chapter 6: Pityriasis Rosea

INTRODUCTION

KEY POINTS

  • Pityriasis rosea can present with various morphologies and includes numerous variants.

  • In darker skin, this can be papulosquamous and pink to brown, violaceous, or gray in color, in contrast to lighter skin, where it is typically pink to salmon colored.

  • In darker skin, there is also a papular morphology variant that can be seen.

  • The herald patch in darker skin often has a darker central hue, which can range from violaceous to brown to gray with a lighter peripheral rim. The overlying scale can also be more difficult to appreciate in darker skin.

image

FIGURE 6-1.

Discrete pink papules and plaques in a Christmas-tree distribution on the back, representing classic presentation of pityriasis rosea in a lighter-skinned person. (Reproduced with permission from Taylor SC, Kelly AP, Lim HW, et al. Taylor and Kelly’s Dermatology for Skin of Color, 2nd ed. New York, NY: McGraw Hill; 2016, Figure 25-4B.)

A patient with annular dark pink patches and papules scattered on the back with a narrower pattern at the top of the back and a wider pattern at the lower back.
View Full Size||Download Slide (.ppt)
FIGURE 6-2.

Pink-gray scaly plaques mimicking psoriasis, diffusely scattered on the back and posterior upper extremities. (From Usatine RP, Smith MA, Mayeaux EJ Jr, et al. The Color Atlas and Synopsis of Family Medicine, 3rd ed. New York, NY: McGraw Hill; 2019, Figure 159-7. Reproduced with permission from E.J. Mayeaux, Jr., MD.)

A photo shows oval, dry, whitish lesions in the back, aligned diagonally downwards.
View Full Size||Download Slide (.ppt)
FIGURE 6-3.

Pink papules in a Christmas-tree distribution along Langer lines, with a prominent red-brown plaque on the left mid-back representing the herald patch. (Reproduced with permission from Kang S, Amagai M, Bruckner AL, et al. Fitzpatrick’s Dermatology, 9th ed. New York, NY: McGraw Hill; 2019, Figure 31-8.)

The image shows a photograph depicting vesicular pityriasis rosea, with typical primary plaque and secondary papulovesicles in a Christmas tree distribution.
View Full Size||Download Slide (.ppt)
FIGURE 6-4.

Perifollicular skin-colored papules on the upper mid-back extending onto the shoulders. The papular variant of pityriasis rosea is seen more commonly in people with skin of color. (Reproduced with permission from Taylor SC, Kelly AP, Lim HW, et al. Taylor and Kelly’s Dermatology for Skin of Color, 2nd ed. New York, NY: McGraw Hill; 2016, Figure 25-8.)

A patient with many skin colored brown papules spread across the upper back and extending toward the shoulders.
View Full Size||Download Slide (.ppt)
FIGURE 6-5.

Another variant of pityriasis rosea is seen here as pink to pink-gray scaly plaques on the lateral neck, extending to the lateral jawline. (Reproduced with permission from Taylor SC, Kelly AP, Lim HW, et al. Taylor and Kelly’s Dermatology for Skin of Color, 2nd ed. New York, NY: McGraw Hill; 2016, Figure 25-9B.)

A patient with dark pink plaques covered with whitish grey scales scattered on the neck and along the jawline.
View Full Size||Download Slide (.ppt)
FIGURE 6-6.

Pink to salmon-colored, oval-shaped, annular plaque with overlying trailing scale, which represents the classic presentation of a herald patch in lighter skin. (Reproduced with permission from Taylor SC, Kelly AP, Lim HW, et al. Taylor and Kelly’s Dermatology for Skin of Color, 2nd ed. New York, NY: McGraw Hill; 2016, ...

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.

This site uses cookies to provide, maintain and improve your experience. MH Privacy Center Close