A BSTRACT Background: The post-COVID period has been associated with various systemic complications, including dermatological manifestations. Understanding the spectrum of cutaneous manifestations following coronavirus disease of 2019 (COVID-19) infection is essential for early diagnosis and appropriate management. This study aims to assess the prevalence and types of cutaneous manifestations in patients recovering from COVID-19 at a tertiary care center. Methods: A cross-sectional observational study was conducted at the Dermatology, Venereology, and Leprosy (DVL) outpatient department of Bharati Vidyapeeth (Deemed to be University) Medical College and Hospital, Sangli, over a period of 6 months. A total of 50 patients presenting with new or worsening cutaneous symptoms at least 4 weeks after COVID-19 recovery were included. Clinical and demographic data were documented, and dermatological examinations were performed. Results: The most commonly observed cutaneous manifestation was telogen effluvium (30%), followed by herpes infection (20%), acne (16%), and pityriasis rosea (6%). Other conditions included lichen planus, psoriasis, vasculitis, erythema multiforme, vitiligo, and dermatomyositis. Middle-aged individuals were predominantly affected, and females exhibited a higher prevalence (58%) than males (42%). Conclusion: Post-COVID cutaneous manifestations exhibit a diverse range of presentations, necessitating a multidisciplinary approach for timely recognition and intervention. Further studies with larger sample sizes are required to establish potential mechanisms linking COVID-19 with dermatological sequelae.

Superficial fungal skin infections are common but often misdiagnosed, which may result in inappropriate treatment and the worsening of symptoms. An accurate and timely diagnosis is essential to differentiate these infections from similar conditions such as secondary syphilis, annular psoriasis, and pityriasis rosea. This single-centre prospective cohort study at the National Skin Centre, Singapore, evaluated the diagnostic agreement between direct microscopy and fungal culture. Between August and December 2022, 268 skin scrape samples were collected from 149 patients with suspected fungal infections. Microscopy identified 67 (25.0%) positives, while fungal culture detected 42 (16.7%) positives. Among the 252 samples tested with both methods, 213 (84.5%) showed concordant results (κ = 0.487, p < 0.0001), a finding that indicates moderate agreement. The most commonly cultured organisms were Trichophyton rubrum and T. mentagrophytes. Our findings suggest that both microscopy and fungal culture may be performed to prevent true-positive cases from being missed. However, in cases where cost is a concern, microscopy can be selected as an initial diagnostic tool. Should microscopy be negative in cases with high clinical suspicion for fungal infection or when empirical treatment fails, culture remains a valuable follow-up test. These findings support a stepwise diagnostic approach—using microscopy first, then followed by culture when necessary—to improve diagnostic accuracy while enabling timely treatment.

Pityriasis rosea (PR) is a fairly common dermatoses that we encounter in our daily practice. PR usually presents in its classical form; however, a few atypical variants have been described in the literature that may sometimes offer a diagnostic dilemma to the dermatologist. We describe a case of a 28-year-old male who presented with itchy lesions over his body, including the palms, for 5 days. Upon detailed history taking, clinical examination, and appropriate investigations, a final diagnosis of PR manifesting with atypical variants was made. We report the case due to the coexistence of two unusual variations of PR in a single patient.

Introduction: Pityriasis rosea and secondary syphilis can appear clinically similar but have different causes. An accurate diagnosis, supported by clinical evaluation and testing, is key to differentiating and properly treating them. Objective: To perform a comparative analysis between secondary syphilis and pityriasis rosea. Methodology: Twenty-four articles were reviewed, of which sixteen relevant references were selected after applying inclusion criteria. The sources used were Cochrane, PubMed, and Google Scholar, with search terms in multiple languages. The final bibliography addressed key aspects of secondary syphilis and pityriasis rosea, including a comparative analysis between the two diseases. Results: Despite clinical similarities, careful examination and serological testing allow differentiation of pityriasis rosea from secondary syphilis, preventing diagnostic errors and improving clinical management. Conclusions: Pityriasis rosea and secondary syphilis may appear similar, but an accurate diagnosis requires careful clinical evaluation and serological testing. Identifying their differences is crucial for proper management. Keywords: Syphilis, Pityriasis, Dermatosis, Skin.

Pityriasis rosea and pityriasis rosea-like lesions associated with COVID-19: A new data literature review

Dear Editor, Pityriasis rosea (PR) is an acute, self-limited exanthematous disease associated with the endogenous systemic reactivation of human herpesvirus (HHV)-6 and/or HHV-7. The disease typically begins with a single erythematous plaque called the “herald patch” (HP), followed by a secondary generalized, symmetrical eruption. Rarely, PR can be limited only to the herald patch. The clinical and laboratory features of these atypical PR have been poorly investigated. [...]

Psoriasis is an immune-mediated inflammatory skin disease that can cause sharply demarcated, erythematous, and scaly skin lesions often found on the surface of the skin (Nair &amp; Badri, 2025). Although the exact origins of the condition are unknown, environmental and genetic factors may play a role. Numerous genes, including human leukocyte antigen (HLA)-Cw6, loci for the T-helper type 2 and T-helper type 17 pathways, innate immune signaling pathways, and adaptive immune pathways involving CD8 T cells, have recently been identified as potentially linked to psoriasis (Chhabra et al., 2022; Li et al., 2016). The incidence rate varies depending on the country-to-country basis, but it generally falls between 2% and 3% (Damiani et al., 2021). Kaposi varicelliform eruptions (KVE) is a cutaneous infection that is generally caused by a variety of viruses such as herpes simplex virus types 1 and 2 and coxsackievirus A16 in patients with underlying dermatosis. Although the exact pathology of KVE is unclear, the breakdown of the body's defense mechanisms and altered skin barriers could be a potential factor (Çakmak et al., 2015). Antiviral medication with acyclovir is a treatment of choice that is generally combined with antibiotics. However, in some rare cases, mortality can also be reported in the case of systemic viremia (Thappa et al., 2011). On the other hand, severe psoriasis can be life-threatening if an early diagnosis is not made and if associated with various other health issues. Since psoriasis cannot be cured, avoiding triggers, such as changing one's lifestyle and using moisturizers to prevent dry skin, is crucial. However, some of the treatment options available for psoriasis are phototherapy or systemic treatment, topical therapy, corticosteroid treatment, immunotherapy, and methotrexate (Raharja et al., 2021; Cleveland Clinic, 2025). A 28-year-old male person was brought to the hospital with itchy skin and lesions all over the body. He was normal four months ago until he got several hyperpigmented papules on his left hand. These papules quickly spread to other parts of his body within four months, and he also experienced intermittent fever, gradual weight loss, and decreased hearing starting at three to four weeks. After the investigation, it was found that he was suffering from psoriasis vulgaris with Kaposi varicelliform eruptions secondary to second-degree syphilis. Differential Diagnosis: Pityriasis rosea, seborrheic dermatitis, eczema, rickettial infection, chickenpox

Đây là một nghiên cứu can thiệp nhằm đánh giá hiệu quả của erythromycin đường uống trong điều trị bệnh vảy phấn hồng Gibert mức độ trung bình và nặng. Nhóm nghiên cứu được uống erythromycin 250mg 4 viên/ ngày, chia 2 lần, cùng các thuốc khác trong 2 tuần; nhóm chứng không dùng erythromycin đường uống. Sau 4 tuần điều trị, hiệu số điểm mức độ ngứa PNRS (Pruritus Numeric Rating Sacle) của nhóm erythromycin là 1,7±1,3; của nhóm chứng là 1,6±1,4 (p=0,85); hiệu số điểm mức độ bệnh PRSS (Pityriasis Rosea Severity Score) của nhóm erythromycin là 13,7±6,4; của nhóm chứng là 10,1±6,4 (p=0,03). Tỷ lệ khỏi của nhóm erythromycin là 33,3%, cao hơn so với nhóm chứng (20%) nhưng p&gt;0,05. Ở nhóm erythromycin, có 2 trường hợp gặp tác dụng không mong muốn, trong đó 1 trường hợp (3,3%) biểu hiện ở đường tiêu hóa (buồn nôn, đau thượng vị), 1 trường hợp khác (3,3%) biểu hiện trên da (phát ban tạm thời). Erythromycin có thể là một lựa chọn phù hợp trong điều trị vảy phấn hồng mức độ trung bình và nặng.

Immunologic reactions induced by COVID-19 vaccines can manifest in the skin, triggering adverse effects of varying intensity. Although most of these reactions are self-limited and not significant, their identification is complex due to the variability of stimuli affecting the skin. In many cases, these manifestations appear after the second or third dose and tend to resolve without intervention. Patients with a history of allergy are more prone to adverse reactions with the BNT162b2 vaccine, although they can be vaccinated under medical supervision. A total of 133 skin reactions were reported following administration of CoronaVac, including urticaria, angioedema, pityriasis rosea, herpes zoster and maculopapular rashes, while BioNTech has been associated with cases of anaphylaxis and activation of autoimmune diseases. This observational, descriptive and retrospective study is based on a systematic review and meta-analysis of reliable scientific sources, with the purpose of examining the relationship between immune responses and dermatological diseases following vaccination against SARS-CoV-2.

Pityriasis rosea (PR) is a self-limited exanthem associated with the endogenous systemic reactivation of human herpesvirus (HHV)-6 and HHV-7. The disease typically begins with a single erythematous patch on the trunk (herald patch), followed by a secondary eruption of smaller papulosquamous lesions. Rarely, the herald patch may be the only cutaneous manifestation of PR. The present work aimed to examine the clinical and laboratory features of the PR cases characterized by the herald patch as the sole cutaneous manifestation and to compare them with the classic form of PR. An observational, retrospective study was conducted on patients presenting with herald patch as the only sign of PR (cases) and on a series of age- and sex-matched patients who presented with a typical PR pattern (controls). The records of the patients were extracted from a PR registry, which collected data on patients with PR diagnosed from 2003 to 2023 by at least two dermatologists from the same study team. Nineteen patients (eleven males, eight females) with a mean age of 27.1 years presented the herald patch as the only cutaneous manifestation of PR. Nineteen age- and sex-matched patients were considered controls. In the cases, the exanthem duration was shorter than in controls, and the mean HHV-6 and HHV-7 DNA plasma load was lower than in controls. This rare variant of PR might be considered an abortive form of the exanthem that occurs when the HHV-6/7 reactivation from latency is contrasted by a more robust immunological response than in classic PR.

Pityriasis rosea (PR) is an acute exanthematous disease with an uncertain physiopathology, increasingly recognized as potentially drug induced. This study aims to investigate medication triggers associated with PR by analyzing cases reported in the FDA Adverse Event Reporting System (FAERS) database. A retrospective review of 343 PR cases reported in the FAERS database from January 1, 1998, to March 31, 2024, was conducted. Reporting odds ratios (ROR) were calculated to assess associations between PR and specific drug classes, including tumor necrosis factor (TNF) inhibitors and angiotensin-converting enzyme (ACE) inhibitors. Logistic regression analysis evaluated the influence of factors such as sex, age group, and seriousness of outcomes on the occurrence of PR. Females represented 56.3% of cases and the 18–64 age group comprised 55.4% of cases. TNF inhibitors were significantly associated with PR (ROR = 4.1881 [3.1970–5.4865], P < 0.0001), particularly infliximab (ROR = 6.5284 [3.9523–10.7837], P < 0.0001), etanercept (ROR = 3.4921 [2.2873–5.3315], P < 0.0001), and adalimumab (ROR = 3.086 [2.0213–4.7115], P < 0.0001). ACE inhibitors were also associated with PR (ROR = 9.9808 [6.0423–16.4864], P < 0.0001), with higher odds in older patients (OR 14.08 [4.2–47.2], P < 0.0001) and those reporting serious outcomes (OR 9.53 [1.24–72.99], P = 0.03). Based on the FAERS, there has been a consistent rise in PR cases, with TNF inhibitors and ACE inhibitors being associated medication classes tied to PR. Given the limited literature on drug-related triggers and patient demographics, we aimed to highlight the characteristics of PR cases that could enhance awareness and inform better clinical outcomes for affected patients.

Pityriasis rosea (PR) is a prevalent dermatological condition characterized by a distinctive herald patch, followed by secondary eruptions, often forming a "Christmas tree" pattern on the trunk. Despite its recognizable clinical presentation, the etiology of PR remains uncertain, with hypotheses pointing to both infectious and noninfectious origins. Human herpesviruses (HHV) 6 and 7 have been implicated, with evidence suggesting viral reactivation as a potential trigger. Epidemiologically, PR affects children, adolescents, and young adults, with a higher incidence in females. The condition is observed globally, with varying incidence rates and seasonal variations, suggesting an infectious component. While PR is generally benign and self-limiting, it can cause significant discomfort owing to pruritus, and atypical presentations and recurrences complicate diagnosis and management. This review evaluates the current understanding of PR's pathogenesis, highlighting both infectious and noninfectious hypotheses, including viral reactivation and immune response mechanisms. It also examines treatment options, such as antivirals and phototherapy, which have shown varying degrees of effectiveness. Further research is needed to clarify etiological factors and to explore the efficacy and safety of various treatment modalities. Understanding these aspects is crucial for improving patient outcomes and developing targeted therapies, especially for atypical or recurrent cases.

Abstract Pityriasis rosea (PR) is a self-limiting inflammatory skin condition primarily affecting adolescents, with a slight female predominance. It typically presents with a herald patch followed by smaller lesions in a characteristic “Christmas tree” distribution. Uncommon presentations localized to atypical sites are rarely reported. This case series highlights the potential for PR to present in atypical localized patterns. Dermatologists should consider PR in the differential diagnosis of localized erythematous plaques and rely mostly on histopathological confirmation for accurate diagnosis.

Artificial intelligence for the diagnosis of erythematous-squamous dermatological diseases: technological contributions to primary care

Pityriasis Rosea in Children - Cases reports and review

ABSTRACT Rashes are abnormal changes in colour and texture of skin. It may be associated with or without pruritus. There are many types of rashes such as eczema, granuloma annulare, lichen planus, and pityriasis rosea. Sometimes, liver cyst poses the symptoms of pruritus. The present case report presented rashes on forearm and leg initially, later trunk and back was involved. Pulmonary involvement was noted along with hypercalcemia. The diagnosis came out to be sarcoidosis after detailed evaluation. Finally, treatment through conservative approach was conducted to improve the symptoms. The findings indicated that gradually the patient responded well to treatment. His fever subsided, and his rash improved. He became clinically better during the time of discharge.

Comment on a Case of Pityriasis Rosea Presenting as Psoriasiform Plaque

Background/Objectives: Pityriasis rosea (PR) is a self-limiting exanthematous disease associated with the endogenous reactivation of human herpesviruses (HHV)-6 and HHV-7. Classically, the lesions gradually resolve, leaving no sequelae. Therefore, the best treatment is reassuring the patient and suggesting a resting period. However, atypical PR cases characterized by extensive, persistent lesions and systemic symptoms may impact the patient's quality of life, and, therefore, a treatment can be prescribed. There is limited evidence on the comparative effectiveness of pharmacological treatments for PR; therefore, we performed a network meta-analysis to compare these interventions. Methods: Overall, 12 randomized control trials (RCTs) were identified. The outcomes were itch resolution and rash improvement. Results were expressed as risk ratio (RR) and 95% confidence interval (CI). We also calculated the relative ranking of the interventions for achieving the aforementioned outcomes as their surface under the cumulative ranking (SUCRA). Results: On network meta-analysis, only oral steroids and the combination of oral steroids+antihistamine resulted significantly superior to the placebo in terms of itch resolution (RR 0.44, CI 0.27-0.72 and RR 0.47, CI 0.22-0.99). Oral steroids resulted in the best treatment (SUCRA 0.90) for itch resolution. In terms of rash improvement, only acyclovir and erythromycin resulted significantly superior to placebo (RR 2.55, CI 1.81-3.58; and RR 1.69, CI 1.23-2.33), and acyclovir outperformed all the other tested interventions. Consequently, acyclovir ranked as the best intervention (SUCRA score 0.92). Conclusions: Acyclovir represents the best option for patients with PR that have extensive, persistent lesions or systemic symptoms. Steroids and antihistamines seemed the best treatment for itch resolution.

Pustular exacerbation of psoriasis precipitated by erythema multiforme like pityriasis rosea

Pityriasis rosea is a benign self-limiting rash, usually lasting 6 to 8 weeks. In classic pityriasis rosea a ‘herald patch’ is the initial finding, a large oval patch usually found on the torso. Smaller, scaly oval pink eruptions follow after 1 to 2 weeks on the chest, back and limbs, and can resemble a Christmas tree pattern on the back. It is seen more commonly in women, with a higher incidence in pregnancy, and has an estimated prevalence of around 1.3%. The rash usually heals without scarring and often no treatment is required. Symptomatic treatment is used occasionally to alleviate pruritus. This article will explore different presentations of pityriasis rosea, how to make a diagnosis and the main management options.