A teenager presented with a skin lesion which appeared as thin oval plaque with a fine collarette of scale located inside the periphery of the plaque. Pityriasis rosea is diagnosed. All of the following are characteristic of pityriasis rosea, EXCEPT:
Pityriasis Rosea (PR): Common acute papulosquamous eruption normally lasting 4-10 weeks. Most often begins as a single 2- to 4-cm thin oval plaque with a fine collarette of scale located inside the periphery of the plaque ("herald patch"). Similar-appearing, but smaller, lesions appear several days to weeks later, typically distributed along the lines of cleavage on the trunk ("Christmas tree" pattern). Usually asymptomatic, sometimes pruritic with mild flu-like symptoms. Occurs most commonly in teenagers and young adults. Probably a viral exanthem associated with reactivation of human herpes virus (HHV)-7 and sometimes HHV-6. Treatment is usually suppoive, although midpotency topical coicosteroids can reduce pruritus; high-dose acyclovir for 1 week may hasten recovery. Ref: Blauvelt A. (2012). Chapter 42. Pityriasis Rosea. In L.A. Goldsmith, S.I. Katz, B.A. Gilchrest, A.S. Paller, D.J. Leffell, N.A. Dallas (Eds), Fitzpatrick's Dermatology in General Medicine, 8e.
Lower respiratory infection
Herald patch
Moderate itching
Low grade fever