Pityriasis rosea is a common skin disease. So called rose pityriasis, because its rash is rose red, slightly higher than the skin, some contain in the skin, size varies, some like small button size, some like coin size, oval, covered with a layer of bran-like thin skin, called bran-like scales.
Rose pity rash is good in the spring and autumn, more young people onset, slightly more women than men, the onset of the initial is in the trunk appear a round light red spot, known as “mother spot”. The mother spot keeps expanding and can even reach the size of an egg. After that, smaller red spots appear one after another on the trunk, which can spread to the neck and proximal extremities, but generally not on the face and lower legs. The rash appears in batches, so the patient can see a rose, yellow-red, yellow-brown, or light brown rash at the same time. Most of these rashes are oval in shape and their long axis coincides with the skin texture.
Patients are usually asymptomatic, with some experiencing itching of varying severity. Individual patients have low fever, headache, general discomfort, sore throat, arthralgia or lymph node swelling and other systemic symptoms.
The course of pityriasis rosea is generally 4 to 6 weeks, also has 2 to 3 months. This disease can also fade by itself without treatment, generally no recurrence. The rash fades first from the center, from rose to yellowish red, from yellowish red to yellowish brown, light brown, until finally disappears, the edge fades later, the surrounding scales form a ring. The rash does not leave any trace after fading.
Is pityriasis rosea “toxic in blood”?
The cause of pityriasis rosea is unknown. There is a theory that pityriasis rosea is caused by viral infection. Therefore, it is said that pityriasis rosea is poisonous in blood. This statement is not scientific. The blood flows all over the body in the blood vessel, if the virus invades the blood, then there will be “toxemia”. Clinical manifestations are high fever, chills, fainting, and even affect the brain, heart, kidneys and other important organs. This is the pityriasis rosea does not have the clinical manifestation, therefore cannot say that the pityriasis rosea is “poisonous in the blood”.
From the point of view of Chinese medicine, pityriasis rosea is also called “wind-heat sore”, is due to the external feeling of wind-heat evil, fries to depress the muscle coup, hair orifice closed, Yang Qi closed and depressed, contains and produces heat, blood heat turns dry, injures and yin liquid, externally floods the skin, therefore also cannot say that pityriasis rosea is “poisonous within the blood “.
The treatment of pityriasis rosea, should be for “wind-heat external attack, blood-heat dryness” cause, treatment is appropriate to dredge wind and clear heat, cool blood moisten dryness method. The formula is used to eliminate wind and heat, cool blood and moisten dryness.
During the medication period, should pay attention to avoid scratching the affected area, avoid eating spicy and oily diet and fishy and windy things.
Pityriasis rosea
General pathological changes
A. Mild hyperkeratosis, wedge-shaped focal hyperkeratosis.
B. Mild hypertrophy of the spinous layer, focal sponge edema, and blister formation in severe cases, especially obvious at the inflammatory infiltration, with wandering lymphocytes in the epidermis, and even small pustules can be formed.
C. Sparse lymphocyte and histiocyte infiltration around the superficial dermal vessels, occasionally eosinophils are seen.
D. Dermal papillae edema.
Pathological differential diagnosis
Drug rash: eosinophil infiltration is significantly more than that of pityriasis rosea.
Punctate psoriasis: neutrophil infiltration is significantly more in lesions with incomplete keratinization and few or no extravascular erythrocytes.
Dermatophytosis: mycelium and spores are visible in the stratum corneum, which can be clearly revealed by PAS staining.
Telecentric annular erythema: generally without dermal papillary edema and extravascular erythrocytes, with a heavy inflammatory infiltrate around the superficial dermal vessels, often in the shape of a cuff.
Clinical features
A. The age of onset is mostly from 10 to 40 years old, with no gender difference, mostly seen in the spring and autumn.
B. The etiology is unknown.
C. Prevalent on the trunk, neck and proximal extremities.
D. The disease starts as an oval or round yellowish rash with a diameter of about 3cm to 5cm, with furfuraceous scales on the edge, and the long axis of the rash is parallel to the skin line, called the pioneer spot.
E. The duration of the disease is 1 month to 2 months, and in chronic cases, it often exceeds 6 months, and generally does not recur.