From the Guidelines
Psoriasis should be managed based on its severity, with consideration of the total body surface area (BSA) involved and the presence of comorbidities, as outlined in the joint AAD-NPF guidelines of care 1. To determine the severity of psoriasis, the Psoriasis Area Severity Index (PASI) can be used, which takes into account the extent and severity of the disease, including the intensity of redness, scaling, and plaque thickness.
- The severity of psoriasis can be classified as mild (<3% BSA), moderate (3%-10% BSA), or severe (≥10% BSA) 1.
- However, psoriasis can be considered severe regardless of BSA if it has serious emotional consequences or occurs in sensitive locations, such as the hands, feet, scalp, face, or genital area, or if it causes intractable pruritus 1.
- The management of psoriasis should be guided by the severity of the disease and the presence of comorbidities, with treatment options ranging from topical therapies to systemic agents and biologics 1.
- It is essential to monitor the response to treatment and adjust the management plan as needed to achieve optimal control of the disease and improve the patient's quality of life 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Definition and Characteristics of Pityriasis Rosea
- Pityriasis rosea is a common acute, self-limited papulosquamous dermatosis that primarily affects children and young adults 2.
- The condition is characterized by a "herald patch" after which oval erythematous squamous lesions appear along Langer's lines of cleavage on the trunk and proximal extremities, giving it a "Christmas tree" appearance 2.
- Pityriasis rosea occurs mainly in individuals between 10 and 35 years of age with a peak during adolescence 2.
Causes and Triggers of Pityriasis Rosea
- Human herpesvirus (HHV)-7 and HHV-6 have been implicated as the causative agents in some patients with pityriasis rosea 2.
- A mild prodrome consisting of headaches, fever, malaise, fatigue, anorexia, sore throat, enlarged lymph nodes and arthralgia is present in about 5% of patients 2.
Diagnosis and Differential Diagnosis of Pityriasis Rosea
- The diagnosis is based on clinical and physical examination findings 3.
- The differential diagnosis includes secondary syphilis, seborrheic dermatitis, nummular eczema, pityriasis lichenoides chronica, tinea corporis, viral exanthems, lichen planus, and pityriasis rosea-like eruption associated with certain medications 3.
Treatment and Management of Pityriasis Rosea
- Treatment is aimed at controlling symptoms and consists of corticosteroids or antihistamines 3.
- In some cases, acyclovir can be used to treat symptoms and reduce the length of disease 3.
- Ultraviolet phototherapy can also be considered for severe cases 3.
- Oral erythromycin may be effective in treating the rash and decreasing the itch 4, 5.
- Acyclovir may lead to increased rash improvement and reduction in itch score 5.