Pityriasis roseaPityriasis roseaSilvia Aslami2010730100Silvia Aslami2010730100Pembimbing :dr. Bowo Wahyudi, Sp. KKJOURNAL RA!"N#introductionPityriasis rosea is a common skin condition characterized by a herald patch an the later appearance of lesion arrayed along langers lines !cleaved lines"$"OLO#%Some pa&ien& wi&h pi&yria'i' ro'ea 'how an in(rea'e in B )ympho(y&e', a de(rea'e in $ )ympho(y&e'.A)&hough &he e&io)ogy o* pi&yria'i' re'ea i' un()ear, 'e+era) *a(&or' indi(a&e an in*e(&iou' (au'e.$he re'u)&' o* one '&udy 'howed e)e+a&ed )e+e)' o* human herpe'+iru' in pa&ien&' wi&h pi&yria'i' ro'ea.Chlamydiapneumoniae,Legionellapneumophila,dan Mycoplasmapneumoniae also have been suggested as potensial infectious agents in pityriasis rosea.!"A#NOS"S#he $rst symptoms of pityriasis rosea are nonspeci$c and consistent %ith a viral upper respiratory infection&A'eraldpatchthenapprears( typically on the trunkhis large lesion is commonly 2 to 10 cmindiameter(ovoid(erythematous andslightlyraised(%ithatypical collarette of scale at the margin Atthisstage(the diagnosisusually remains unclear&)icroscopic e*aminationsof potassium hydro*ide preparationssho%s no fungal element&+,-./0 1& 'erald patch %ith collarette of scale at the margin&Afe%daystoafe%tooa fe%%eeksafterthe appearanceoftheherald patch(corpsofsmaller lesions(1to10mmin diameter( develop across the trunkand(lesscommonly( on the e*tremitiesheselesionsaresalmon colored(ovoid(raisedand havethesamecollaretteof scaleastheheraldpatch !$gure 2"& Atthisstage(thediagnosis usually is clear( particularly if the physician can observe or elicitahistoryoftheherald patch&+,-./0 2& 2lassic pityriasis rosea of the lo%er abdomen %ith associated herald patch&,fthediagnosisisuncertain( especiallyifthepalmsandsolesare a3ectedandpatientisse*ually activesecondarysyphilisa45/6 test( or dark7$eld microscopy&+,-./0 3& #ypical oblong trunk lesions of pityriasis roseahesmaller secondarylesions ofpityriasisrosea follo%langersline& (Figure 3)& 8henthelesions occurontheback( theyalignina typical92hristmas tree:or9$rtree: pattern&+,-./0 3& #ypical oblong trunk lesions ofpityriasis rosea&+,-./0 ;& lesions aligning along langers lines&0lse%hereonthe body(thelesions follo%thecleavage linesasfollo%s< transverselyacross thelo%erabdomen andback( circumferentially aroundtheshoulders( andina47shaped patternontheupper chest& (Figure 4).+,-./0 1& ,nverse form of pityriasis rosea( %ith peripheral distribution&Pityriasisroseacan occurinaninverse formin%hichthe e*tremitiesare a3ectedbutthe trunkisspared& (Figure 5).+,-./0 1& ,nverse form of pityriasis rosea( %ith peripheral distribution&=iopsyusuallyisnotindicatedinthe evaluationofpatients%ithsuspected pityriasis rosea&'istologyhassho%nthatinaddition tononspeci$csubacuteanchronic in>ammation(11percentof specimenscontainepidermalcells thatdisplaydyskeratotic degeneration/ecurrenceoftheconditionlaterin life is rare&$RA$,N$#herushofpityriasisroseatypically lastsabout1%eeksandresolveby? %eeks in more than ?0@ of patients&Animportantgoaloftreatmentisto controlpruritus(%hichmaybesevere in 21 @ of patient&+orpatient%ithseverepruritus( e*perts have recommended treatment %ithzinco*ide(calaminelotion(oral antihistamines( and even oral steroids&.ltraviolet radiation( through arti$cial sources or intentional e*posure to natural sunlight( has been recommended to decrease the duration of rash and intensity of itching in patients&Patientsshouldbeadvisedaboutthe selflimitednatureofpityriasisrosea andabouttheneedtocontacttheir physicianiftherashorprurituslasts more than three months&$han- %ou