What are the other Names for this Condition? (Also known as/Synonyms)

• Atypical Variant of Pityriasis Rosea

What is Atypical Pityriasis Rosea? (Definition/Background Information)

• Atypical Pityriasis Rosea is a benign skin disorder characterized by the presence of a skin rash. It is diagnosed when the signs and symptoms are not typical, like those observed in most cases of pityriasis rosea. The “atypical features” of Atypical Pityriasis Rosea makes its diagnosis more challenging
• In  Atypical Pityriasis Rosea, multiple large plaques can be present without the prior appearance of single herald patch. The term “herald” referring to a signifier of an expected event. The signs and symptoms of Atypical Pityriasis Rosea are mostly confined to the head and neck region. The head and neck are usually spared in typical pityriasis rosea (PR)
• Most Typical Pityriasis Rosea cases present with an initial ‘herald patch”, a single 2-3 inch patch of rash, which persists, followed about a week later by multiple smaller similar spots on the same body region. Areas usually affected in typical PR are the chest, back, and abdomen region; followed by the arms and legs, and the axilla and groin region
• Atypical Pityriasis Rosea generally affects individuals between 10-35 years of age and occurs most often during fall and spring seasons. The exact cause of the condition is not known, but it may be linked to a viral infection
• Mild cases of Atypical Pityriasis Rosea require no treatment. The application of corticosteroids and antihistamines on the rash can help control itching and redness. Generally, the disorder has a good prognosis; the skin lesions mostly resolve with no long-term complications being noted

To summarize, Atypical Pityriasis Rosea is different from the normal pityriasis rosea, in that it does not have a herald patch, and affects a body region not involved in normal PR.

Who gets Atypical Pityriasis Rosea? (Age and Sex Distribution)

• Although individuals of all ages and gender may be affected by Atypical Pityriasis Rosea, it is mostly seen in children, teens, and young adults; between 10-35 years of age
• Women are more susceptible to this disorder than men
• The condition is observed worldwide; no racial or ethnic predilection is noted

What are the Risk Factors for Atypical Pityriasis Rosea? (Predisposing Factors)

The risk factors associated with Atypical Pityriasis Rosea are:

• Children and young adults in the 10-35 age group category
• Female gender

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Atypical Pityriasis Rosea? (Etiology)

• Atypical Pityriasis Rosea is a variant of pityriasis rosea. The exact cause of the condition is unknown
• However, it is believed that the rash could be triggered by certain viral infections (such as human herpes virus type 6)
• Atypical Pityriasis Rosea is not a contagious condition and does not spread from one individual to another

What are the Signs and Symptoms of Atypical Pityriasis Rosea?

The signs and symptoms of Atypical Pityriasis Rosea include:

• The skin patches are mostly present on the head and neck region. It can also affect the groin and armpits and may involve the mucosa of mouth too
• Multiple large plaques can be present instead of a single herald patch (a large, oval-shaped patch); in some cases, it may also be absent
• Sometimes, the patch can be present without an associated, generalized rash
• Blistering of the skin (presence of vesicles)
• Target skin lesions (erythema multiforme like lesions)
• The skin may be scaly and can have severe itching
• The rashes follow unseen embryologic lines of the skin, appearing in a Christmas tree like pattern

Unlike in classical pityriasis rosea where the presence of plaque is observed, in Atypical Pityriasis Rosea, the herald patch may be absent. The viral rashes may last about 3 months in classical pityriasis rosea, but in Atypical Pityriasis Rosea, it may be present for a longer duration of time. Also, multiple recurrences of the symptoms may be observed.

How is Atypical Pityriasis Rosea Diagnosed?

In general, it is difficult to diagnose Atypical Pityriasis Rosea. The diagnostic tools may include:

• Through and careful examination of the skin rash: In most cases, a diagnosis of Atypical Pityriasis Rosea cannot be made though a skin examination only
• A microscopic examination of scraped off skin flakes (KOH exam) to eliminate the diagnosis of cutaneous fungal infection
• Skin biopsy: A skin biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis
• The presentation of Atypical Pityriasis Rosea and pityriasis rosea can mimic secondary syphilis. A blood test for syphilis is frequently done to rule out this possibility

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Atypical Pityriasis Rosea?

Complications of Atypical Pityriasis Rosea are very rare, but may include:

• Severe itching
• After the rash itself resolves, the affected areas may have residual increase or decrease in pigment
• Recurrences are not uncommon, but are of little consequence

How is Atypical Pityriasis Rosea Treated?

The treatment of Atypical Pityriasis Rosea involves:

• Mild cases may not require any treatment
• Topical corticosteroids can be applied to ease the itching sensation and redness
• Oral antihistamines can be used to help with itching
• Ultraviolet B (UVB) phototherapy can help reduce itching

How can Atypical Pityriasis Rosea be Prevented?

Currently, there are no known measures to prevent Atypical Pityriasis Rosea. Preventive activities aim at reducing the effect of itching and scratching. These include:

• Soaking in lukewarm to warm water
• Taking an oatmeal bath
• Application of moisturizing creams and lotions
• Wearing light cotton or silk clothing is helpful
• Gentle, mild soaps shall be used; deodorant soaps should be avoided

What is the Prognosis of Atypical Pityriasis Rosea? (Outcomes/Resolutions)

• The prognosis of Atypical Pityriasis Rosea is good. The condition lasts only for few weeks or at the most 6 months
• The skin disorder generally resolves completely on its own without the presence of any long-term complications

Additional and Relevant Useful Information for Atypical Pityriasis Rosea:

• Pityriasis rosea appears in the beginning with a herald patch - a single, oval-shaped patch on the chest, followed by smaller rashes after 2 weeks

The following article link will help you understand pityriasis rosea:

https://www.dovemed.com/diseases-conditions/pityriasis-rosea/