Pityriasis folliculorum revisited

Six cases of facial erythema with follicular plugging are described. These cases correspond with characteristics of the disorder pityriasis folliculorum, a presumed demodicidosis. Treatment modalities included topical tretinoin, gamma benzene hexachloride (lindane) lotion, and 1% permethrin cream rinse.

Pityriasis rotunda as a cutaneous marker of hepatocellular carcinoma: a comparison with its prevalence in other diseases

In an attempt to substantiate the claim that pityriasis rotunda may be a useful cutaneous marker of hepatocellular carcinoma in South African Blacks, the prevalence of the rash in 63 unselected South African Blacks with this tumour was compared to that in 63 matched patients with active tuberculosis, 63 with other malignant tumours, and 63 with various forms of chronic benign hepatic disease. The prevalence of pityriasis rotunda in hepatocellular carcinoma was 15.9%, which was appreciably greater (P = 0.0005) than the overall prevalence of the rash (2.6%) in the controls. The prevalence was 4.8% for tuberculosis (P = 0.038), 0% for other malignant diseases (P = 0.0007), and 3.2% for chronic benign hepatic disease (P = 0.015). We conclude that the presence of pityriasis rotunda is a useful pointer to the diagnosis of hepatocellular carcinoma in South African Blacks.

Pityriasis rosea in Lagos

A recent 5-year period study of the incidence of pityriasis rosea among dermatologic outpatients was conducted at the Lagos University Teaching Hospital. Three hundred fifty-two patients with pityriasis rosea were seen. The average annual incidence was 4.8 per 100 dermatologic patients. Women predominated by a margin of 1.2:1.0. More than 91% of the patients were between the ages of 5 and 35 years, with a peak at ages 10-14. The incidence of the disease was significantly higher in the early part of the rainy season. No declining incidence was observed over the years. A blood picture of a leukopenia with relative lymphocytosis was observed early in the disease. Ampicillin, when consumed after the onset of the eruption, made the patient with pityriasis rosea clinically worse.

Pityriasis lichenoides et varioliformis acuta and acquired toxoplasmosis

A patient presented with a typical pityriasis lichenoides et varioliformis acuta (PLEVA) and disclosed serological evidence of an active and recent toxoplasmosis. Specific treatment of toxoplasmosis promptly and definitively resolved PLEVA lesions. Serological tests for Toxoplasma gondii should be performed in all PLEVA patients.

Pityriasis rosea and the need for a serologic test for syphilis

A rapid plasma reagin (RPR) test was performed in fifty patients with a clinical diagnosis of pityriasis rosea to determine the frequency of syphilis as the underlying cause of the eruption. In none of the fifty patients was syphilis the cause. Experience in diagnosing skin diseases, frequency of syphilis in the community served, and the characteristics of the individual eruption are important factors in the decision to perform an RPR test.

Pityriasis rotunda in a white patient. Report of the second case and review of the literature

A 19-year-old white woman with pityriasis rotunda in whom no diagnosable disorder could be demonstrated is reported on herein. Pityriasis rotunda has been described in Oriental and black patients, usually in association with certain serious systemic diseases. Our patient appeared to have the second reported case of pityriasis rotunda in white persons. In both cases the dermatosis occurred in an otherwise healthy individual. Physicians should be alert to the possible occurrence of pityriasis rotunda in white patients. The literature on pityriasis rotunda is reviewed.

Pityriasis rosea update: 1986

Pityriasis rosea is a common self-limited dermatologic disorder. It appears to be a nonspecific cutaneous reaction pattern with a large number of causes. Current evidence indicates that a cell-mediated immune mechanism may be important in its pathogenesis.

Pityriasis rotunda. A cutaneous marker of hepatocellular carcinoma in South African blacks

Although paraneoplastic phenomena occur frequently in patients with hepatocellular carcinoma, cutaneous changes have rarely been reported. During the past two years, ten South African blacks with hepatocellular carcinoma and pityriasis rotunda have been seen in a single hospital. The rash affected the trunk, especially the lower back and buttocks. The lesions ranged in size from 1.5 to 25 cm and were always multiple. They had a characteristic circular or arcuate configuration with scaling and varying degrees of hyperpigmentation. Pityriasis rotunda may prove to be a useful cutaneous marker of hepatocellular carcinoma in South African blacks.

Pityriasis rotunda: two cases in black Americans

Pityriasis rotunda is an uncommon cutaneous disorder consisting of asymptomatic, perfectly circular, scaling plaques on the trunk and extremities. Histopathologic findings are consistent with ichthyosis vulgaris. The majority of cases are seen in association with an underlying disease, and most authors believe that this entity represents a form of acquired ichthyosis. Previous cases have been restricted to certain geographic and ethnic groups (most commonly Japanese and South African Bantu). We report two cases of pithyriasis rotunda, both occurring in black Americans. We believe that these are the first reported cases seen in Americans.

Pityriasis rosea

Pityriasis rosea is a common, self-limited, scaling disorder of unknown etiology, seen predominantly in young adults. The lesions, typically found on the trunk and proximal extremities, are ovoid, salmon-colored and symmetric. A "herald patch" appears in 70 percent of cases. Variants appear frequently. Papular, urticarial, vesicular or hemorrhagic lesions may be seen. Management with antipruritic lotions, emollients or antihistamines may be necessary to relieve itching.

[Observations on pityriasis rosea patients]

In the Institute of Skin and Veneral Diseases 252 patients suffering from pityriasis rosea were treated yearly since 1970. As opposed to descriptions published so far several differences were observed. The disease occurs not only in young adults, but also in infants and in old age. It may be observed not only in certain months, but throughout the year. The disease becomes manifest more frequently in workers of larger collectives. It does not leave behind prolonged immunity, but may return after an intervall of 1-12 years with milder symptoms. The repeated incidence was 3,57 per cent. Recurrence was observed in two cases within one family. P.r. was followed by herpes zoster in 3 cases, which is indicative of increased susceptibility for viral infection. The point of attack of the supposed pathogen is the pharyngeal mucous membrane, which may explain the difficulty of isolation of the unknown virus as this region has a rich microflora.

Recent upper respiratory tract infection and pityriasis rosea: a case-control study of 249 matched pairs

A sample of 249 patients was drawn from an original population of 939 patients with pityriasis rosea identified in an earlier population-based study of pityriasis rosea in Rochester, Minnesota. A control was selected for each case, matched for age, sex, and year of diagnosis. Comparison was made with regard to recent immunization, history of atopy, and recent infection. A statistically significant number of patients had experienced recent upper respiratory tract infection (P less than 0.005). The association between recent infection and pityriasis rosea is discussed.

Pityriasis rosea in Rochester, Minnesota, 1969 to 1978

A population-based epidemiologic study of pityriasis rosea was developed for Rochester, MN, for a recent 10-year period. Nine hundred thirty-nine patients with pityriasis rosea (340 male patients and 599 female patients) who resided within Rochester city limits at the time the diagnosis was made were included. The average annual incidence rate of this disease was 172.2 per 100,000 person-years (158.9 per 100,000, adjusted to the 1970 U.S. white population). Female patients predominated by a margin of 1.5:1.0. More than 75% of the patients were between the ages of 10 and 35 years, with a mean age of 22.7 years and a range of 10 months to 78 years. There was a recurrence of the illness in 1.8% of the patients after an average of 4.5 years of follow-up. The highest rate was noted in 1972, following which there was a steady and significant decline in incidence. The incidence of the disease was significantly higher in the colder months than in the warmer season. Patients in twenty-one close-contact pairs experienced the disease at varying intervals. Recent past infections or history of atopy was noted in nearly one third of the cases.

Case clustering in pityriasis rosea: support for role of an infective agent

One hundred and twenty-six cases of pityriasis rosea seen over two years in north Staffordshire were analysed for clustering in time and space. A statistically significant degree of clustering was found; this was evident among female patients considered separately but not among male patients. The incidence of the condition was higher in patients working in, or attending, educational establishments. These findings support the hypothesis that pityriasis rosea is caused by an infective agent. A search for an infective organism and a transmission mechanism now seems justifiable.

Pityriasis rosea. Viral complement fixation studies

Eleven patients were seen for pityriasis rosea and underwent acute and convalescent viral complement fixation tests for several respiratory viruses and Mycoplasma. Several patients (6/11) gave a history of antecedent upper respiratory illness; however, no significant rise in titer was seen on any of the complement fixation tests.