• Pityriasis Rosea: Tis the Season

    There is a rash that has gotten the nickname of the “Christmas Tree Rash” and though it usually doesn’t happen in December, the name fits. This rash is a response to a viral infection and the pattern of the rash can have red patches on the back that appear at the same angles of a christmas tree’s branches. Not every patient will have this pattern, but it is unique finding for this rash. I saw a gentleman from Ballantyne with a perfect pattern of the rash and his wife had also noticed the funny orientation of his rash.

    The rash often starts with a larger lesion that we call the “Herald Patch” because it heralds the arrival of the many smaller lesions that can follow. The rash may have only a handful of lesions or over 100. Some people have itching that is unbearable while others have come in simply to find out what is growing on their skin. I saw a woman from Matthews recently who was asymptomatic, but had nearly 50 lesions on the trunk and arms. She didn’t want treatment, she just wanted to know how she got it and when it would go away. Many different viruses can cause this rash and we don’t do any bloodwork as the virus is likely gone by the time the rash has appeared. The rash may last weeks, but I have already seen a gentleman from Steel Creek who had the rash come and go over nearly four months.

    Most people only get this rash once in a lifetime. One percent of people are susceptible to repeated cases of pityriasis rosea. Yesterday I saw two people in one day that have become repeat PR rash victims. One was from Fort Mill and one from the South Park area. They are both bothered by their rash and unhappy campers.

    The treatment usually is a topical steroid and in severe cases oral steroids are needed. The good news is that PR is harmless and easily treated. The seasons for PR tend to be in the spring and fall, when more viruses tend to cycle, not christmas. The rash may last up to 3 full months if left untreated. Ho Ho Ho.

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