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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. [ABSTRACT FROM AUTHOR]

Background: Preliminary data support the possible use of ultraviolet‐induced fluorescence (UVF) dermoscopy in general dermatology, yet no accuracy analysis has been performed so far. Objective: To evaluate diagnostic accuracy of UVF dermoscopy in clinically similar non‐neoplastic conditions as compared to polarized light‐based dermoscopy. Methods: Patients with dermatoses potentially showing UV‐induced findings were considered; cases were grouped according to clinical patterns and controls were also included. Standardized evaluation of dermoscopic pictures of the target lesion along with comparative and accuracy analysis were performed for polarized and UVF dermoscopic findings. Results: A total of 208 patients were included [31 foot intertrigo (7 due to Pseudomonas, 13 due to Corynebacterium and 11 due to dermatophytes); 57 intertrigo of major creases (18 inverse psoriasis, 13 erythrasma, 15 tinea infections and 11 candidiasis); 16 acne (papulopustular) and 13 Malassezia folliculitis; 46 papulosquamous dermatoses (14 guttate psoriasis, 11 lichen planus, 12 pityriasis rosea and 9 pityriasis lichenoide chronica); and 45 hypopigmented macular dermatoses of the trunk (9 progressive macular hypomelanosis, 9 idiopatic guttate hypomelanosis, 13 vitiligo and 14 achromic pityriasis versicolor)]. Significant (p < 0.01) UVF was seen in several conditions: green in Pseudomonas foot intertrigo; red in Corynebacterium foot intertrigo, inverse and guttate psoriasis (arranged around dermal papillae in the former), progressive macular hypomelanosis (folliculocentric distribution) and erythrasma (showing polygonal or structureless appearance); blue fluorescent concretions along hair shaft in erythrasma; light green in achromic pityriasis versicolor and tinea of major creases; and blue follicular in Malassezia folliculitis. Additionally, both acne and achromic pityriasis versicolor were also associated with interruption of uniform follicular red fluorescence. Notably, polarized and UVF dermoscopy were related to the most accurate feature in nine and eight analysed dermatoses, respectively. Conclusions: UVF dermoscopy improves recognition of non‐neoplastic dermatoses, yet it should be considered complimentary to polarized light‐based dermoscopy to increase diagnostic performance. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Erythemato-squamous diseases (ESDs), also known as erythrodermas, are a group of dermatological disorders characterized by both redness (erythema) and scaling (squamous) of the skin. These conditions can have various causes and implications. The implications of ESDs vary depending on the specific condition and its severity. While some may cause mild symptoms and have minimal impact on daily life, others can be chronic, recurrent, and significantly affect a person's physical and emotional well-being. Treatment options for these conditions may include topical medications, oral medications, phototherapy, and lifestyle modifications. In this paper, state of art machine learning (ML) algorithms is implemented for classification of ESD. To classify the disease a set of 11 clinical features and 23 histopathological features are considered. The performance of the ML classifiers is analyzed with individual sets of features and combination of both. Further, the performance of the ML classifiers is analyzed at different training rates to know the superior classifier for ESD classification. Furthermore, the study is extended to investigate the effectiveness of the Kruskal-Wallis algorithm in ranking the importance of features in the dataset used for disease classification. An investigation depicts that Ensemble and SVM classifiers outperformed the other ML classifiers in terms of accuracy and F1-score.

Pityriasis rosea is a well-known, common skin dermatosis in clinical practice. It has a benign self-limiting character and most often does not require any treatment. It is probably caused by reactivation of the human herpes virus-6 and -7. Usually, it occurs in children and young adults and presents a typical course with numerous scaly plaques on the trunk and extremities preceded by the onset of a herald patch. The diagnosis is based on clinical symptoms, however in some of the cases, dermatoscopy, histopathology or other examinations may be helpful to establish the correct diagnosis. Although the disease is typically not dangerous, it can be a therapeutic challenge, especially when its course is atypical or when it occurs during pregnancy and may pose a risk to the fetus. The literature on pityriasis rosea was analyzed to check whether new insights regarding its etiopathogenesis have appeared, or treatment approach has been changed.

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. [ABSTRACT FROM AUTHOR]

Pityriasis rosea is an acute, self‐limited exanthem that typically occurs in adolescence and young adulthood, classically featuring ovoid erythematous and scaly lesions on the trunk and proximal extremities. While its cause is not definitively known, the classic form of pityriasis rosea may result from the reactivation of latent human herpesvirus (HHV) infections (HHV‐6 and HHV‐7). Interestingly, drug eruptions that clinically and/or histopathologically resemble pityriasis rosea have also been reported. These pityriasis rosea‐like drug eruptions tend to occur at an older age and have a shorter duration than the classic type. As there are different management paradigms, the distinction between classic pityriasis rosea and the mimicking drug eruption is important to recognize. Herein, we report a case of a pityriasis rosea‐like drug eruption that occurred in association with imatinib mesylate treatment for chronic myeloid leukemia. We also review the clinicopathologic features of reported cases of pityriasis rosea‐like drug eruption, including those due to imatinib. While the clinical morphology of the cutaneous drug‐related eruption mimics the lesions seen in classic pityriasis rosea, the presence of unique histopathologic findings, including necrotic keratinocytes, interface dermatitis, and eosinophils, may aid in distinction. [ABSTRACT FROM AUTHOR]

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Background: The epidemiology of skin diseases is difficult to map out because patients rarely seek care, and this is especially true for children and adolescents in resource-limited settings. The availability of only a few trained dermatologists in the workforce in Cameroon widens this knowledge gap. Understanding the pattern of common skin diseases in pediatric patients is crucial for accurate development of public health interventions and research. Methods: We conducted a hospital-based, cross-sectional study at the pediatrics and dermatology outpatient units at Douala Laquintinie Hospital (DLH) from January 2019 to December 31, 2022. Results: A total of 3947 patients were included. The mean age was 6.19 ± 5.31 years with a M/F sex ratio of 1/1.17. Immunoallergic and infectious skin diseases constituted 82.2% of the sample. Eczema predominated (n = 786, 19.91%) and was followed by prurigo (n = 680, 17.23%), scabies (n = 357, 9.04%), impetigo/furuncles (n = 313, 7.93%), dermatophyte infections (n = 265, 6.71%), and acne (n = 191, 4.84%). Prurigo was associated with the rainy season (p = 0.028). Acne [aOR = 1.66 (1.23-2.26), p = 0.001] and pityriasis rosea [aOR = 2.25 (1.47-3.45), p < 0.001) were more likely diagnosed in females while dermatophyte infections were more likely diagnosed in males [aOR = 1.42 (1.03-1.95), p = 0.031]. Conclusion: Overall, 23.97% of children and adolescents consulted at DLH have a skin disease. The top three skin diseases diagnosed among children and adolescents were eczema, prurigo, and scabies. [ABSTRACT FROM AUTHOR]

Background: Following the COVID-19 virus pandemic, the globe has begun immunization programmers using a variety of vaccines. Objective: Our study aimed to recognize dermatological responses emerging in response to the COVID-19 vaccines delivered in Egypt and to ascertain their clinical characteristics and potential contributing variables. Materials and method: Individuals over the age of 18 who experienced dermatological reactions after receiving the COVID-19 vaccine were included in the study between December 2021 and December 2022. The evaluation used an electronic survey on Google forms that were created by the research team and had its validity and reliability evaluated by five dermatology-specific doctors. A routine survey that questioned questions about age, gender, place of residence, smoking, medical history, allergy, number of doses and when cutaneous reactions started after immunization. According to the severity of the symptoms following the vaccination, dermatological reactions were grouped. Result: The study comprised a total of 1000 patients, of which 413 men (41.3%) and 587 women (58.7%). It was found that COVID arm (25.2%), pityriasis rosea (13.6%), vasculitis (11.4%), and lichen planus (9.2%) were the dermatological conditions and reactions that arose most commonly following immunization. After delivery of the vaccine, the rate of dermatological reactions was 63.8% (with 41.6% reported mild symptoms, 15.6% reported moderate symptoms, and 6.6% reported severe symptoms). The patients who received the immunizations experienced a statistically significantly increased number of responses (p = 0.001). Conclusion: The most common reactions in our sample were COVID arm, pityriasis rosea, and Vasculitis. [ABSTRACT FROM AUTHOR]

Erythemato-squamous diseases (ESDs), also known as erythrodermas, are a group of dermatological disorders characterized by both redness (erythema) and scaling (squamous) of the skin. These conditions can have various causes and implications. The implications of ESDs vary depending on the specific condition and its severity. While some may cause mild symptoms and have minimal impact on daily life, others can be chronic, recurrent, and significantly affect a person's physical and emotional well-being. Treatment options for these conditions may include topical medications, oral medications, phototherapy, and lifestyle modifications. In this paper, state of art machine learning (ML) algorithms is implemented for classification of ESD. To classify the disease a set of 11 clinical features and 23 histopathological features are considered. The performance of the ML classifiers is analyzed with individual sets of features and combination of both. Further, the performance of the ML classifiers is analyzed at different training rates to know the superior classifier for ESD classification. Furthermore, the study is extended to investigate the effectiveness of the Kruskal-Wallis algorithm in ranking the importance of features in the dataset used for disease classification. An investigation depicts that Ensemble and SVM classifiers outperformed the other ML classifiers in terms of accuracy and F1-score. [ABSTRACT FROM AUTHOR]

Pityriasis rosea (PR) is an exanthematous disease associated with the endogenous systemic reactivation of human herpesvirus (HHV)-6 and/or HHV-7. Variants of PR characterized by atypical lesion morphology, eruption course, and severe symptoms have already been described, but their prevalence is probably underestimated. We report herein two patients suffering from anorexia nervosa (AN) who developed a very rare form of purpuric PR. So far, no cases of PR in AN patients have been reported in the literature. In AN, impaired cell-mediated immunity may favor the endogenous systemic reactivation of HHV- 6 and/or HHV-7, causing PR. Furthermore, an increased level of the vascular cell adhesion molecule 1, interleukin 6, and tumor necrosis factor-α has been demonstrated in AN patients, which may be responsible for their increased vascular dysfunction.

The article discusses eruptive hypomelanosis, a paraviral exanthem in children characterized by hypopigmented macules following a viral infection. The condition was first described in 2014 and is part of a group of skin eruptions known as paraviral exanthem, which includes various distinct entities triggered by viral infections. Eruptive hypomelanosis is transient and self-limiting, with no active management required, and further research is needed to understand its etiologies. Differential diagnoses include pityriasis alba, pityriasis versicolor, and postinflammatory hypomelanosis. [Extracted from the article]

Background: Psoriasis is an inflammatory skin disease driven by upregulation of cytokines in the Th17 pathway, including interleukin‐36 (IL‐36). Previous studies have highlighted the utility of IL‐36 immunostaining for psoriasis compared to spongiotic dermatitis and other psoriasiform dermatoses; however, no study has examined the role of IL‐36 staining in distinguishing psoriasis from pityriasis rosea (PR) and pityriasis lichenoides (PL), known histologic mimickers of psoriasis. Methods: We compared the immunostaining pattern of IL‐36 for 21 PR cases, 22 PL cases, and 10 psoriasis cases. We graded the immunostaining as 0, negative; 1, focal weak; 2, diffuse weak; 3, focal, strong; or 4, diffuse strong. We further categorized stains as negative (0–2 score) or positive (3–4 score) and utilized Fisher's exact test to compare the immunostaining pattern of these entities. Results: All psoriasis specimens were positive for IL‐36, whereas all PR specimens were negative (p = 0.00000002). Twenty PL specimens were negative (p = 0.000001). Nine of 10 pityriasis lichenoides et varioliformis acuta cases were negative (p = 0.00012), and 11 of 12 cases of pityriasis lichenoides chronica were negative (p = 0.00003). Conclusions: Our findings highlight the potential role of IL‐36 immunostaining in distinguishing psoriasis from other psoriasiform dermatoses, including PR and PL. [ABSTRACT FROM AUTHOR]

Background: Plaque psoriasis is relatively straightforward to identify. When diagnostic concerns arise in atypical cases, a biopsy is needed. It is widely accepted that the Munro microabscess and the spongiform pustule of Kogoj are diagnostic pathological features. However, the diagnostic dilemma is likely to arise in cases without these specific pathological changes and typical clinical features. This study aimed to investigate clinical and pathological clues in distinguishing atypical plaque psoriasis from its mimics. Methods: We evaluated the clinicopathological features of 20 cases of atypical plaque psoriasis and 40 cases of psoriasis mimics as controls including pityriasis rosea (n = 10), pityriasis lichenoides chronica (n = 8), and subacute dermatitis (n = 22). Results: A retrospective analysis of the clinicopathological characteristics of patients with atypical plaque psoriasis and controls was performed. Pathologically, there were significant differences between the two groups in the types of parakeratosis (P = 0.046), epidermal capture of extravasated erythrocytes (P = 0.011), focal basal liquefied degeneration (P = 0.017), types of inflammatory cells (P = 0.000), and depth of inflammation (P = 0.000). Clinically, we found the presence of scales and crusts was significantly different between the two groups. Conclusion: This study offers insight into the clinicopathological features of atypical plaque psoriasis. These differential diagnostic features, compared with its mimics, are proposed to assist the clinician in the diagnosis and treatment of atypical plaque psoriasis. [ABSTRACT FROM AUTHOR]

An acute inflammatory skin condition called pityriasis rosea is characterized by papulosquamous skin lesions that develop on the trunk and extremities. Both children and adults are affected by the illness, with somewhat more females than males. The Medline, Pubmed, Embase, NCBI, and Cochrane databases were searched for studies of patients with non-alcoholic fatty liver disease. Incidence, etiology, and management options were analyzed. Pityriasis rosea has an easy-to-understand diagnostic that is mostly based on clinical features with an appropriate time course. Pityriasis rosea has no specific treatment. [ABSTRACT FROM AUTHOR]

This article discusses intertriginous skin disorders, which are common in general practice and can range from benign conditions to chronic diseases. These disorders occur in areas where opposing skin surfaces come into contact, such as the groin folds, axillae, and natal cleft. The article emphasizes the importance of a thorough history and physical examination in diagnosing these disorders and provides a list of common intertriginous skin disorders and their first-line management options. It suggests that referral to a dermatologist may be necessary in certain cases. Overall, the article concludes that most intertriginous skin disorders can be successfully managed in primary care. [Extracted from the article]

Pityriasis rosea is a common, self-limited disease which in its typical form should not raise diagnostic doubts. Nevertheless, its atypical presentations can be a challenge for the clinician, and hence it is important to be aware of them. Recognition of these forms may enable a correct diagnosis to be made and avoid unnecessary procedures. We present two patients for whom we believe atypical PR was the most likely the diagnosis. [ABSTRACT FROM AUTHOR]

Background: Due to their overlapping clinical and histopathological features, the definitive diagnosis of papulosquamous skin diseases can only be made through clinicohistopathological association. Methods: Over a period of 18 months, we studied 100 patients with clinically suspected non-infectious papulosquamous skin lesions. Diagnosis was confirmed through histopathological examination using haematoxylin and eosin stain. The clinical pattern was associated with histopathological findings. Results: The results showed that the majority of the patients were in the age group of 21–30 years, with a male preponderance. The upper limbs were the most frequently involved site. Psoriasis was the most common papulosquamous skin disease, followed by lichen planus, pityriasis rosea, pityriasis rubra pilaris, lichen nitidus, pityriasis lichenoides, lichen striatus and parapsoriasis. Psoriasiform reaction was found to be more common than lichenoid tissue reaction. The study demonstrated a positive clinicohistopathological association in 86% of cases. Conclusions: Histopathology confirmed the diagnosis in 86% of cases, provided the diagnosis in 6% of cases and was non-contributory in 8% of cases. [ABSTRACT FROM AUTHOR]

Hao Wu, Qing-Jie Ji, Yu-Yang Xu, Jian-Wei Zhu Department of Dermatology, Quzhou TCM Hospital at the Junction of Four Provinces Affiliated to Zhejiang Chinese Medical University, Quzhou, People’s Republic of ChinaCorrespondence: Jian-Wei Zhu, Email zjwmed@163.comAbstract: Pityriasis rosea (PR) is a common inflammatory, erythematous and scaly skin condition that usually affects individuals aged from 20 to 40 years old. The disease often exhibits a self-limiting course up to 6– 8 weeks. We report a 25-year-old female patient with a six-month history of red scaly rashes on the trunk and proximal limbs, accompanied by severe pruritus that has been remained ineffective conventional treatments. She was diagnosed as persistent pityriasis rosea. As abrocitinib has been proved to be effective for many inflammatory diseases, therefore in this case, we tried abrocitinib for the patient, and a good result had been achieved.Keywords: pityriasis rosea, abrocitinib, JAK-STAT pathway

Background: Pityriasis Rosea (PR) is a common, yet enigmatic, dermatological condition characterized by a distinctive clinical presentation. Despite its prevalence, the aetiology and pathogenesis of PR remain elusive. Aims: To study the epidemiological and clinical aspects of patients with PR. To study dermoscopic findings and carry out histopathological correlation. Methods: A cross-sectional study of 50 patients was conducted. A detailed clinical history was taken and an examination was done followed by a dermoscopy. Quantitative data like age and duration of disease are presented with the help of standard deviation. Qualitative risk factors, like gender, age groups, symptomatology, site of lesion, findings or cutaneous examination, dermoscopy findings, and histopathology findings, are presented with the help of frequency and percentages. Results: PR shows male preponderance and mean age of occurrence being 30.8 ± 15.7 years. Forty per cent of patients had an atypical clinical presentation. The most frequently seen dermoscopy findings were diffuse red background (58%), peripheral collarette scale (62%), and peripheral dotted vessels (50%). On histopathology, the most common findings were spongiosis (44%), parakeratosis (38%), irregular acanthosis (34%), perivascular lymphocytic infiltrate (56%), and red blood cell extravasation (36%). Limitations: Sample size was less due to COVID. As this was a corss-sectional study follow up of patients could not be done. Conclusion: While the diagnosis of PR is clinical, it is difficult in atypical cases where dermoscopy comes to the aid. It also helps identify the age of lesions, thus helping decide the treatment strategy for patients. Biopsy remains the gold standard in ruling out other differentials of PR.

The article discusses a case study of a 38-year-old male with nodular granulomatous secondary syphilis, a rare presentation of the disease. The patient had a history of a painless ulcer on the glans penis and multiple episodes of unprotected sexual exposure. Diagnosis was aided by dermoscopy, revealing Biett's collarette, and confirmed through positive VDRL and TPHA tests. Treatment involved benzathine penicillin and antiretroviral therapy due to co-infection with HIV. The article highlights the importance of recognizing atypical presentations of secondary syphilis and the utility of dermoscopy in diagnosis. [Extracted from the article]

The article discusses a case of vesicular syphilis that mimicked subepidermal immunobullous disease in a 33-year-old man. Initially misdiagnosed as pityriasis rosea, the patient's condition improved with penicillin G treatment. The case highlights the importance of considering syphilis as a differential diagnosis in atypical presentations, emphasizing the need for a comprehensive diagnostic workup. The study was approved by MacKay Memorial Hospital IRB and conducted by researchers from the Philippines and Taiwan. [Extracted from the article]

Traditional herbs have a history of clinical use in anti-fatigue. However, several adverse effects of herbs have been identified. Pityriasis rosea-like eruption (PR-LE) is a rare cutaneous complication of herbs. To the best of our knowledge, there have been few reports of PR-LE following herbs. Here, we described a case of PR-LE that developed 6 days after taking anti-fatigue herbs. After the 17 days of stopping Aconitum carmichaelii Debx and Panax Ginseng, it notably faded. So, when anti-fatigue herbs being authorized for fatigue use, monitoring for potential adverse effects is necessary. [ABSTRACT FROM AUTHOR]

Purpose: The study aimed to describe the dermoscopic features of pityriasis rosea among patients attending the skin clinic at Mbarara Regional Referral Hospital. Patients and methods: A hospital‐based cross‐sectional descriptive study conducted for a 6‐month period in the skin clinic of MRRH in Southwestern Uganda. Data were collected from consecutively recruited patients using structured questionnaires. Patients with a clinical diagnosis of pityriasis rosea were examined using a dermoscope and subsequently sent for KOH and TPHA tests to rule out fungal skin infection and secondary syphilis, respectively, and then received routine care at the skin clinic. Results: There were 54 patients with pityriasis rosea seen. Dermoscopy was done on a total of 162 lesions of which 19 were herald patches, 51 were truncal lesions, 52 on the extremities while 40 were on the face and neck regions. Common dermoscopic features consisted of a violaceous background noted in 145 (89.51%), white scales in 161 (99.38%), diffuse scale distribution in 57 (35.19%), perifollicular scale type in 61 (37.65%), and brown‐dotted pigmentary changes in 66 (40.74%). Other unique findings noted in a few lesions were cloudy structures, petechial spots, erosions, and punched out pits. Conclusion: Most prevalent dermoscopic features included: a violaceous background, white scales, diffuse scale distribution, perifollicular scale type, brown‐dotted pigmentary changes with no visible blood vessels nor follicular changes. Other unique less frequently seen findings were cloudy structures, petechial spots, erosions, and punched out pits. [ABSTRACT FROM AUTHOR]

Pityriasis rosea is a well-known, common skin dermatosis in clinical practice. It has a benign self-limiting character and most often does not require any treatment. It is probably caused by reactivation of the human herpes virus-6 and -7. Usually, it occurs in children and young adults and presents a typical course with numerous scaly plaques on the trunk and extremities preceded by the onset of a herald patch. The diagnosis is based on clinical symptoms, however in some of the cases, dermatoscopy, histopathology or other examinations may be helpful to establish the correct diagnosis. Although the disease is typically not dangerous, it can be a therapeutic challenge, especially when its course is atypical or when it occurs during pregnancy and may pose a risk to the fetus. The literature on pityriasis rosea was analyzed to check whether new insights regarding its etiopathogenesis have appeared, or treatment approach has been changed. [ABSTRACT FROM AUTHOR]

Recent studies have focused on the role of human herpesvirus 6 (HHV-6) and human herpesvirus 7 (HHV-7) in PR etiology with varying results. In our study, with the approach that the discrepancy between the results may be related to the different samples and techniques used, we aimed to clarify the etiology by examining tissue and plasma samples using molecular methods and evaluating the results together with serological parameters. Skin biopsies and plasma samples of twenty-five PR patients were tested to detect HHV-6 and HHV-7 DNA using calibrated quantitative real-time polymerase chain reaction (CQ RT-PCR). IgG and IgM antibodies against HHV-6 and HHV-7 were tested by enzyme-linked immunosorbent assay and indirect immunofluorescence. Of the patient group, 64% were positive for HHV-6 IgG without IgM positivity. HHV-6 DNA was present in seven tissue and ten plasma samples. HHV-7 positivity was 100% and 12% for IgG and IgM antibodies, respectively. HHV-7 DNA was detected in four tissue samples and one plasma sample. Patients with HHV-7 DNA-positive plasma and tissue samples had also HHV-7 IgM antibodies. In conclusion, our results seem to support the role of HHV-6/HHV-7 in the etiology of PR. To clarify the etiology of PR and avoid confusion, the collection of different biological materials simultaneously and the usage of CQ RT-PCR as a diagnostic technique are recommended. [ABSTRACT FROM AUTHOR]

Pityriasis rosea, is an acute self-limiting papulosquamous inflammatory disorder. It usually starts with a herald patch on the trunk and proximal extremities, followed by scaly oval patches that give them a “Christmas tree” appearance. The lesions may be associated with fever a rash. The disease can present as numerous morphologies such as papular, urticarial, lichenoid, and generalized that may be confused with other conditions such as secondary syphilis, seborrheic dermatitis, nummular eczema, pityriasis lichenoides chronica, tinea corporis, viral exanthems, lichen planus, and PR like eruption linked to particular drugs. We report a rare case of polymorphic pityriasis rosea in paediatric age group.

Luca Potestio,&ast; Fabrizio Martora,&ast; Sara Cacciapuoti, Matteo Megna, Alessia Villani, Angelo Ruggiero Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy&ast;These authors contributed equally to this workCorrespondence: Angelo Ruggiero, Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, Napoli, 80131, Italy, Tel +39 - 081 – 7462457, Fax +39 - 081 – 7462442, Email angeloruggiero1993@libero.itAbstract: COVID-19 pandemic completely changed every aspect of human life. Several measures were adopted to limit the spreading of the infection. Among these, vaccination was the main one. Globally, vaccination campaign was a success, showing to be efficient in controlling and preventing the SARS-Cov2 infection, reducing the risk of disease progression, hospitalization, and mortality. However, with the increasing number of vaccines administered, several cutaneous reactions were described, making dermatologists key players in their recognition and treatment. Among these, also viral reactivations have been described. In particular, cases of Pityriasis Rosea (PR) and PR-like reactivations have been collected. An early diagnosis is mandatory to avoid mistreatments. In this context, we conducted a review of the current literature investigating cases of PR following COVID-19 vaccination with the aim of understanding the possible pathogenetic mechanisms and causal correlation as well as to investigate the risk of this cutaneous eruption, to offer clinicians a wide perspective on the linkage between PR and COVID-19 vaccines.Keywords: COVID-19, vaccination, pityriasis rosea, safety

Introduction: Mucocutaneous complications or adverse events due to SARS-CoV-2 infection or vaccination have been well delineated in the literature, respectively. Most eruptions are considered mild and self-limiting; however, for the atypical cases with a tentative clinical diagnosis, performing a biopsy and histopathological assessment is pivotal to confirm the diagnosis and subsequently prescribe a more tailored treatment. Despite the diverse reporting of such incidents globally, most studies restrict the rate of biopsied cases to less than 15%. Case Presentations: This case series elucidates 20 patients referred to the tertiary dermatology clinic, including 14 COVID-19 infection-related eruptions such as lichen planus (LP), cutaneous vasculitis, pityriasis rosea (PR), discoid lupus erythematosus, guttate psoriasis, sarcoidosis, Raynaud’s phenomenon, non-specific lesions resembling genital warts, Beau’s line, and one severe case of purpura fulminans with a promising outcome. Moreover, we presented six vaccine-induced cases comprising LP, urticarial vasculitis, PR, parapsoriasis, and localized morphea. The diagnosis of all challenging cases has been proven by histopathological evaluation. We included pertaining anamnesis details of each patient and vivid classifying images to pinpoint the morphologic features of each condition. Discussion: In line with our previous studies, the vaccine-induced eruptions were less severe compared to infection-related complications of COVID-19 and are mostly controllable by antihistamines and corticosteroid administration. Therefore, reporting such events should not impede COVID-19 vaccination in the general population.

Background Psoriasis (PS), vitiligo (VT), and Pityriasis rosea (PR) are chronic skin diseases often occurring as a consequence of exaggerated immune responses. These skin manifestations can be triggered as a result of the molecular mimicry between viral protein (s) and host protein (s), which could generate auto-antibodies. In addition, it can be hypothesised that skin diseases are manifestations of the reduced immunity that is observed in chronic hepatitis B virus (HBV)-infected individuals. Aims and Objective To investigate the presence of HBV in PS, VT, and PR cases and Human Herpes Virus (HHV) 6 and 7 in PR cases. Materials and Methods DNA extracted from healthy controls (n = 20), PS (n = 10), VT (n = 11), and PR (n = 12) were subjected to HBV-S gene-specific polymerase chain reactions (PCRs) and HHV 6-UL57 and HHV7-UL10 gene-specific PCRs. PCR products of positive samples (HBV and HHV 6 and 7 DNA) of expected length were bi-directionally sequenced using overlapping primers. Sequence identification was performed by NCBI BLAST and analysed by multiple sequence alignment. HBV DNA copy number was determined through quantitative real-time PCR. The blood samples were also tested for HBV serological markers and Interferon gamma (IFN-γ) by enzyme immunoassays. Results The PCR data and Immunoassay study revealed that seven out of 12 PR, six out of 10 PS, and six out of 11 VT cases had signs of HBV infection. HHV 6 DNA was detected in four, whereas HHV 7 DNA was found in two of the 12 PR blood samples. PR6 presented the evidence of both HHV 6 and 7 co-infections. Conclusion Observing the correlation of HBV with skin diseases, albeit at the pilot level, a larger study is warranted to identify HBV infection in skin disease patients. The evidence of HHV 6 and HHV 7 DNA in PR cases supports the HHV infection linkage with PR.

This article presents a case study of a 10-year-old girl with gray-brown patches in the axillary and inguinal folds. The girl had been unsuccessfully treated with topical cream and oral medication for a presumed tinea infection. Further examination revealed gray-brown macules and patches in the affected areas, as well as perifollicular pigment deposits. Biopsies confirmed the diagnosis of lichen planus pigmentosus inversus (LPPI). LPPI is a rare variant of lichen planus characterized by asymptomatic or mildly itchy pigmented lesions in skin folds. Treatment options include topical corticosteroids or calcineurin inhibitors. [Extracted from the article]

Pityriasis rosea is a common skin condition that primarily affects children and young adults. It is characterized by the appearance of a herald patch, followed by a secondary rash of pink oval papules and plaques. The rash typically forms a "Christmas tree-like" pattern on the trunk, upper arms, and upper thighs. Diagnosis is usually made based on clinical presentation and does not require a skin biopsy. The condition is self-limiting and resolves within six to eight weeks. Treatment involves providing information and reassurance to patients, managing any itching with skincare advice, topical corticosteroids, and oral antihistamines. In severe cases, narrowband ultraviolet B phototherapy may be considered. [Extracted from the article]

This article discusses a case of scabies with an unusual presentation, known as "scabies surrepticius" or "scabies incognito." Scabies is typically characterized by generalized excoriated, pruritic papules and burrows in specific areas of the body. However, in this case, the patient presented with pruritic papular lesions all over the body, including perforating lesions and abscesses. The diagnosis was confirmed through histopathology, which revealed the presence of the mite Sarcoptes scabiei. The article emphasizes the importance of considering scabies as a differential diagnosis in atypical presentations and highlights the need for comprehensive tissue examinations for accurate diagnosis. [Extracted from the article]

Background: Pityriasis Rosea (PR) is a common, yet enigmatic, dermatological condition characterized by a distinctive clinical presentation. Despite its prevalence, the aetiology and pathogenesis of PR remain elusive. Aims: To study the epidemiological and clinical aspects of patients with PR. To study dermoscopic findings and carry out histopathological correlation. Methods: A cross-sectional study of 50 patients was conducted. A detailed clinical history was taken and an examination was done followed by a dermoscopy. Quantitative data like age and duration of disease are presented with the help of standard deviation. Qualitative risk factors, like gender, age groups, symptomatology, site of lesion, findings or cutaneous examination, dermoscopy findings, and histopathology findings, are presented with the help of frequency and percentages. Results: PR shows male preponderance and mean age of occurrence being 30.8 ± 15.7 years. Forty per cent of patients had an atypical clinical presentation. The most frequently seen dermoscopy findings were diffuse red background (58%), peripheral collarette scale (62%), and peripheral dotted vessels (50%). On histopathology, the most common findings were spongiosis (44%), parakeratosis (38%), irregular acanthosis (34%), perivascular lymphocytic infiltrate (56%), and red blood cell extravasation (36%). Limitations: Sample size was less due to COVID. As this was a corss-sectional study follow up of patients could not be done. Conclusion: While the diagnosis of PR is clinical, it is difficult in atypical cases where dermoscopy comes to the aid. It also helps identify the age of lesions, thus helping decide the treatment strategy for patients. Biopsy remains the gold standard in ruling out other differentials of PR. [ABSTRACT FROM AUTHOR]

Subacute cutaneous lupus erythematosus (SCLE) is a condition that might pose a diagnostic challenge. The aim of this study was to assess the usefulness of videodermoscopy in the differentiation of SCLE from other erythematous-desquamative dermatoses. Consecutive patients with SCLE (n = 27), psoriasis (n = 36), nummular eczema (n = 30), mycosis fungoides (n = 26), and pityriasis rosea (n = 20) referred to our Department of Dermatology were recruited for this study. A representative lesion was visualized using a Canfield D200EVO Videodermatoscope (Canfield Scientific GmbH, Bielefeld, Germany) and evaluated for the following parameters: vessels (morphology and distribution), scales (color and distribution), follicular findings, colors and morphologies, and presence of specific clues. SCLE was predominantly characterized by a polymorphous vascular pattern (92.6%) of unspecific distribution (92.6%) over a pink-red background (74.1%). Gray-brown dots were present in 10 (37.0%) cases, and pigmentation was noted in 15 (55.6%) patients, including peripheral pigmentation in 7 (25.9%) patients. Videodermoscopic evaluation showed significant differences between SCLE and psoriasis, which was characterized by regularly distributed dotted vessels. Although some common dermoscopic features with MF were noted, the presence of yellow structureless areas and red dots/globules favored the diagnosis of MF. In conclusion, a polymorphic vascular pattern, especially in association with gray-brown dots and/or peripheral pigmentation, is a valuable clue for the differentiation of SCLE from other erythematous-desquamative dermatoses. [ABSTRACT FROM AUTHOR]

Objective To describe and compare the dermoscopic features of various papulosquamous skin disorders. Methods This study is an observational descriptive comparative study performed on 169 patients with papulosquamous skin diseases including psoriasis, lichen planus, eczema, pityriasis rosea and pityriasis lichenoides chronica at the outpatient clinic at the dermatology department of AL-Sader teaching hospital in Basra during the period between April 2021 to September 2022. A detailed history was taken from each patient with a complete physical examination and all relevant investigations were done. The dermoscopic examination was done using a hand-held dermoscope (x10) and photos were taken with a mobile phone camera attached to the Dermlight DL200 dermoscope then data were collected and statistically analyzed. Results Dermoscopic examination of psoriasis showed that light red background, regularly dotted vessels and diffuse white scales were the most common findings. The most characteristic dermoscopic features of lichen planus was Wickham striae which was seen as radial streaming followed by a reticular pattern, the lesion was purple in color, non-scaly and non-vascular lesions, the scales if present were mainly peripheral white scales, while the vascular lesions of lichen planus were usually dotted peripheral blood vessels. Patchy dotted blood vessels on a dull red background covered by yellow-white scales in patchy distribution were the common findings seen in eczema. According to a study of patients with pityriasis rosea, the most significant dermoscopic features observed in patients were yellow background color, peripheral white scales, and avascular pattern. Pityriasis lichenoides chronica was found to be associated with peripheral dotted vessels on orangeyellow background covered by white scales on a peripheral or diffuse pattern. Conclusion Dermoscopy is a simple non-invasive safe bedside tool that provides important information to help in diagnosis or narrowing differential diagnosis of many papulosquamous skin diseases. [ABSTRACT FROM AUTHOR]

In the wake of a global COVID-19 pandemic, where innovations in vaccination technology and the speed of development and distribution have been unprecedented, a wide variety of post-vaccination cutaneous reactions have surfaced. However, there has not been a systematic review that investigates pityriasis eruptions and the associated variants following COVID-19 inoculations. A PubMed search using Preferred Reporting Items for Systematic Reviews and Meta-Analyses was performed to find case reports from the earliest record through November 2022. Data including types of vaccination and pityriasis were extracted and a quality review was performed; 47 reports with 94 patients were found: 64.9% had pityriasis rosea (PR), 3.2% PR-like eruptions, 16.0% pityriasis rubra pilaris, 7.4% pityriasis lichenoides et varioliformis acuta, 3.2% pityriasis lichenoides chronica, and 5.3% had reactions described as atypical. The top three COVID-19 vaccinations reported were Pfizer-BioNTech (47.9%), Oxford-AstraZeneca (11.7%), and Moderna (8.5%). Pityriasis reactivity was reported most frequently after the Pfizer-BioNTech vaccination, with pityriasis rosea being the most common variant. A large difference was additionally found between the ratio of post-vaccination pityriasis reactions following Pfizer and Moderna vaccinations (5.63), and the ratio of Pfizer's usage in the United States as of December 28, 2022 relative to that of Moderna (1.59). Further studies with adequate follow-up periods and diagnostic testing will thus need to be performed to elucidate the root of this discrepancy and better characterize the association between different pityriasis reactions and COVID-19 vaccinations. [ABSTRACT FROM AUTHOR]

Introduction: Mucocutaneous complications or adverse events due to SARS-CoV-2 infection or vaccination have been well delineated in the literature, respectively. Most eruptions are considered mild and self-limiting; however, for the atypical cases with a tentative clinical diagnosis, performing a biopsy and histopathological assessment is pivotal to confirm the diagnosis and subsequently prescribe a more tailored treatment. Despite the diverse reporting of such incidents globally, most studies restrict the rate of biopsied cases to less than 15%. Case Presentations: This case series elucidates 20 patients referred to the tertiary dermatology clinic, including 14 COVID-19 infection-related eruptions such as lichen planus (LP), cutaneous vasculitis, pityriasis rosea (PR), discoid lupus erythematosus, guttate psoriasis, sarcoidosis, Raynaud's phenomenon, non-specific lesions resembling genital warts, Beau's line, and one severe case of purpura fulminans with a promising outcome. Moreover, we presented six vaccine-induced cases comprising LP, urticarial vasculitis, PR, parapsoriasis, and localized morphea. The diagnosis of all challenging cases has been proven by histopathological evaluation. We included pertaining anamnesis details of each patient and vivid classifying images to pinpoint the morphologic features of each condition. Discussion: In line with our previous studies, the vaccine-induced eruptions were less severe compared to infection-related complications of COVID-19 and are mostly controllable by antihistamines and corticosteroid administration. Therefore, reporting such events should not impede COVID-19 vaccination in the general population. [ABSTRACT FROM AUTHOR]

Many skin manifestations of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection reflect activation of cutaneous and systemic immune responses involving effector pathways of both the innate and adaptive arms of the immune system. This article reviews evidence from the recent clinical and scientific literature that informs the current understanding of the consequences of coronavirus disease 2019 (COVID-19)-induced immune cell activation, as relevant to dermatology. Topics include the clinical consequences of autoantibody production in patients with COVID-19, immunologic evidence for chilblains as a manifestation of SARS-CoV-2 infection, and the relationship between type I interferons and COVID-19 disease severity.