Atypical Pityriasis Rosea with Unilateral Presentation

Abstract

Pityriasis Rosea (PR) is a common skin disease and characterized by generalized scaly eruptions typically on the trunk and proximal extremities. Atypical presentations of PR are common and can be a diagnostic challenge for clinicians. Here we present a case of a 26-year-old female who presented with a sudden onset of several asymptomatic, erythematous and scaly plaques on her trunk. Plaques sized 0.5-1cm in diameter that were distributed unilaterally (right side) on her chest, back and axilla. Atypical cases of PR are fairly common and less readily recognized. Careful history, clinical evaluation and follow-up are important to avoid misdiagnosis of PR and physicians should be aware of PR variants so that appropriate management and reassurance can be offered. For atypical eruptions without a definite diagnosis, it is safer to consider lesional skin biopsy.

Keywords: Scaly eruptions; Skin biopsy; Skin disease.

[Table/Fig-1]:

Unilateral distribution of skin eruptions and peripheral collaret scaling of the lesions.

[Table/Fig-2]:

Histologic picture. Skin tissue is seen with mound of parakeratosis, mild acanthosis/ Dermis shows edema, mild perivascular lymphocytes infiltrate and extravasated RBC (H&E staining 10X).