From the Research
The pathophysiology of pityriasis rosea is believed to involve viral reactivation, particularly human herpesvirus 6 (HHV-6) and human herpesvirus 7 (HHV-7), though the exact cause remains incompletely understood. This self-limiting skin condition typically begins with a "herald patch," a single large oval lesion, followed by the eruption of smaller, salmon-colored, oval patches along skin tension lines in a "Christmas tree" pattern, primarily on the trunk and proximal extremities. The disease process involves a cell-mediated immune response to the viral antigens, leading to inflammation in the skin. Histologically, there is mild to moderate spongiosis, parakeratosis, and a perivascular lymphocytic infiltrate in the dermis.
Some key points to consider in the pathophysiology and management of pityriasis rosea include:
- The condition usually resolves spontaneously within 6-12 weeks without scarring 1.
- Treatment is generally supportive with antihistamines and topical steroids for symptom relief, as no antiviral therapy has proven consistently effective 2.
- The condition rarely recurs and does not cause long-term complications, though it may cause significant temporary discomfort and cosmetic concerns for affected individuals 3.
- Atypical forms of pityriasis rosea have been described, and a comprehensive classification of the disease has been proposed to help identify these forms and establish the best treatment options 3.
- Pityriasis rosea during pregnancy has been linked to spontaneous abortions, and active intervention may be considered for pregnant women with the disease 1.
Overall, the management of pityriasis rosea should focus on relieving symptoms and preventing complications, while also considering the potential risks and benefits of treatment in different patient populations. The most recent and highest quality study on the topic, published in 2021, provides a comprehensive review of the clinical manifestations, evaluation, diagnosis, and management of pityriasis rosea 1.