Pityriasis Rosea

  • Medical Author:
    Gary W. Cole, MD, FAAD

    Dr. Cole is board certified in dermatology. He obtained his BA degree in bacteriology, his MA degree in microbiology, and his MD at the University of California, Los Angeles. He trained in dermatology at the University of Oregon, where he completed his residency.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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How is pityriasis rosea diagnosed?

Pityriasis rosea is usually diagnosed solely on the basis of its appearance, particularly the onset of the distinct large herald patch and the symmetrical Christmas tree presentation. Also, the herald patch tends to have a fine scale with a definite border, the so-called "collarette." To rule out other types of skin disorders, a physician may scrape the skin and examine the scales under the microscope to detect fungus infection that could mimic pityriasis rosea. Also, blood tests including rapid plasma reagent (RPR) may be done to detect secondary syphilis, which also may mimic pityriasis rosea. In some cases, a skin biopsy may be required to rule out skin conditions.

What are some common misdiagnoses of pityriasis rosea?

The first herald patch of pityriasis rosea may look very similar in appearance to ringworm (tinea corporis). Pityriasis rosea has also been mistaken with eczema and psoriasis, which can occur as similar scaly patches, but not in the same distribution as pityriasis rosea.

Pityriasis rosea may be misdiagnosed as

Medically Reviewed by a Doctor on 2/25/2016

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