Pityriasis Rosea
Medical Author: Nili N. Alai, MD, FAAD
Medical Editor: William C. Shiel Jr., MD, FACP, FACR
What is pityriasis rosea?
Pityriasis rosea is a common rash usually seen in individuals between the
ages of 10 to 35 years old. The rash typically lasts six to eight weeks, rarely
extending 12 weeks or longer. Once a person has pityriasis rosea, it
generally does not recur in their lifetime.
Pityriasis rosea characteristically begins as an asymptomatic single, large
pink patch called the "herald patch" or mother patch, measuring 2-10 centimeters.
The herald patch is a dry, pink to red patch which appears on the back, chest,
or neck and has a well-defined, scaly border.
One to two weeks following the initial appearance of the herald patch, a
person will then develop many smaller pink patches across their trunk, arms,
and legs. The second stage of pityriasis rosea erupts with a large number of
oval spots, ranging in diameter from 0.5 centimeter (size of a pencil eraser)
to 1.5 centimeters (size of a peanut). The individual spots form a symmetrical
"Christmas tree" pattern following lines of cleavage. This rash is usually
limited to the trunk, arms, and legs, rarely occurring on the face and neck.
Pityriasis rosea generally spares the face, hands, and feet.
Who gets pityriasis rosea?
Pityriasis rosea is, for the most part, equally common between the two sexes,
although there is a slightly higher occurrence reported in women. It generally
occurs in children and young adults between 10-35 years of age.
Pityriasis rosea has no racial predominance. Most people only get pityriasis once in
their lifetime, although it is theoretically possible to have it more than once.
What are signs and symptoms of pityriasis rosea?
Most people do not notice any symptoms with pityriasis rosea except for the
appearance of the rash itself. Mild, intermittent itching is reported in about
50% of individuals affected, especially when people become overheated from
exercise or hot showers. Itching seems to increase with stress. Sometimes
pityriasis is accompanied by flu-like symptoms, such as sore throat, fatigue,
nausea, aching, and decreased appetite. Most people are otherwise in very good
health and don't feel any other symptoms.
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