Pityriasis Versicolor

Pityriasis rosea 

REF: Dermatology. 1995; 190(3): 252. PubMed PMID: 7599393, Clinical Pediatric Dermatology – By Thappa page 104

PITYRIASIS ROSEA

The primary eruption, herald patch (Mother spot) is a single oval or round patch with a central wrinkled salmon colored area and a darker peripheral zone separated by a “collarette of scales” (when stretched across the long axis, the scales tends to fold across the line of stretch, the so called Hanging curtain sign).

Griseofulvin has been approved by U.S. Food and Drug Administration for several dermatophyte infections.

However, because of its limited spectrum of coverage compared to other agents and the lengthy courses required,

Griseofulvin is not used as a first-line therapy for fungal infections other than tinea capitis.

The child in the question is suffering from Pityriasis Alba.

It is characterised by the presence of hypopigmented scaly macules of variable size.

It is  commonly found in the cheek of children and is self limiting.

Topical steroids/ tacrolimus may have a role in certain cases, but is not usually necessary.

Ref: Clinical Manual of Emergency Pediatrics By Ellen F. Crain, 5th Edition, Page 130.

Pityriasis Rosea is a self limiting papulosquamous dermatoses of unknown aetiology characterised by Herald patch, annular plaque with peripheral collarette of scales on the trunk and secondary lesions arranged in Christmas tree/fir tree appearance.

Treatment is usually symptomatic. It resolves in about 8-10 weeks.

Ref: Illustrated Synopsis of Dermatology and STD’s By Neena Khanna, Pages 50-51

Ans. is ‘b’ i.e., Pitryiasis versicolor

Ans. is ‘c’ i.e., M. furfur

Ans: B i.e. Pemphigus vulgaris

Dermatologic conditions and features

• Psoariasis is a chronic dermatosis characterized by presence at typical sites of well defined erythematous papules and plaques, which are surmounted with large, silvery loose scales.
• Pemphigus is an intraepidermal bullous disorder, which is characterized clinically by presence of cutaneous and mucosal blisters and histologically by acantholysis (due to deposition of intercellular antibodies)
• Lichen planus is characterized by 5P’s; Pruritic, polygonal, purple (violaceous), plane (flat topped), papules with Wickham’s striae on surface
• Pityriasis versicolor features include perifollicular, hypopigmented (or hyperpigmented), macules surmounted with branny scales

Ans. C: Pityriasis Rosea

In pityriasis rosea, a single scaling patch (the Herald Patch) often appears one to twenty days before the general rash. It is an oval plaque 2-5 cm in diameter, with a scale trailing just inside the edge of the lesion.

The herald patch is often mistaken as ringworm. It can also be confused with psoriasis.

A few days later, smaller similar scaly patches appear, scattered mainly on the trunk but may spread to the thighs, upper arms and neck.

The oval patches follow the line of the ribs like a fir tree.

They have a dry surface and may have an inner circle of scaling.

The plaques may be a faint pink to a deep red. They may be very itchy, but in most cases they don’t itch at all. Pityriasis rosea usually avoids the face, although sometimes a few spots spread to the cheeks.