Definition

Pitiriasis rosea is a skin disorder characterized by oval-shaped skin patches that can appear in various parts of the body. This disease is quite common and can affect people of all ages, although it usually occurs between ages 10 and 35 years. The column on pitiriasis rosea is characterized by a large oval-shaped rash that is usually found in the chest, stomach, or back which is referred to as Herald patch. In two weeks or more, the rash is usually followed by the development of a scaly red oval rash whose spread resembles a Christmas tree, so the pitiriasis rosea is often referred to as Christmas tree rash. Pitiriasis rosea will usually heal on its own within about 6 to 10 weeks. This disorder is non-communicable and in most cases it will not leave scars or wounds after recovering.

Cause

The exact cause of the pitiriasis rosea is still unclear. Several possible causes of pitiriasis rosea are:

• Viral infections

Herpes 6 and 7 (HHV-6/7) viruses have the strongest relationship known to the occurrence of pitiriasis rosea. The HHV-6/7 virus is not a type of Herpes virus that can cause the emergence of genital warts in humans. Infection of this virus is quite common, especially at an early age. Children are often infected when a person is sneezing or kissing them. Once you are infected with this virus, the virus will remain in the body. These viruses generally do not cause problems because the immune system can control it. There is a possibility that a person is exposed to pitiriasis rosea when the immune system is weakened, which can allow viruses to spread throughout the body and breed.

Other viral infections, such as influenza A H1N1 and COVID-19, are also suspected to be the cause of the pitiriasis rosea.

• Drug-induced reactions

Many drugs have been linked to the occurrence of pitiriasis rosea, such as the inhibition group of an angiotensin-changer enzymes (ACE-inhibitor), non-steroid anti-inflammatory drugs (NSAID), hydrochromatiazid, kappapril, atypical antipsychotic barbiturat, D-penicillamine, imatinib, metronidazol, isotretinoin, Clozapine, and clonidine.

• Vaccine

Pitiriasis rosea can be triggered by the administration of several vaccines, such as Bacillas Calmette-Guerin (BCG), H1N1, diphtheria, smallpox, hepatitis B, Pneumococcus, and COVID-19.

Risk Factors

Some factors that can increase the risk of getting pitiriasis rosea, among others:

• Age. Pitiriasis rosea most often occurs in adolescents and young adults aged 10 to 35 years, but basically can affect people of all ages.
• Gender. Pitiriasis rosea occurs a little more often in women.
• Most of the pitiriasis cases of rosea occur in winter.
• The risk of getting pitiriasis rosea will increase during pregnancy.

Symptoms

Before the rash occurs, patients with pitiriasis rosea will usually experience flu-like symptoms, including:

• Headache
• Fatigue
• Fever
• Sore throat
• Cough
• The lymph nodes in the neck may also feel swollen
• Loss of appetite
• Nausea
• Difficulty Sleeping

Early symptoms of pitiriasis rosea are usually characterized by the emergence of a rash called Herald patch, namely a single oval-shaped rash, large with a diameter of 2 to 5 cm, a higher surface than the surrounding skin, and scaly. This foam often appears in the back, chest, or stomach area.

Beberapa hari hingga beberapa minggu (sekitar 10 hari) setelah Herald patchOther rashes will usually arise from the top of the body to the bottom in the form of smaller scaly spots with a diameter of 1 to 3 cm on your back, chest, or stomach that resemble the pattern of pine trees (Christmas trees). Some rashes can also appear on the thighs, upper arms, and neck, but rare on the face, facial skin, palms, or foot soles. Ruam on pitirisis rosea can cause sometimes severe itching.

If you have dark skin, the pitiriasis rash rosea tends to be purple black to brown. However, if you have bright skin, it is likely that the rash will tend to be pink or resemble a salmon color.

Diagnosed

In diagnosing pitirisis rosea, doctors will start conducting interviews with you. Doctors will usually ask what symptoms you experience, since when symptoms appear, how the development and spread of the rash, and where the rash arises. Subsequently, doctors will perform physical examinations. Doctors will see firsthand the appearance of the rash and assess the pattern of rash spread. Doctors will also feel the skin to assess the surface of the rash which is usually scaly. Basically, the diagnosis of pitiriasis rosea can be enforced based on the results of interviews and physical examinations, in particular with the discovery of Herald patchand a pattern of spreading a rash that resembles a Christmas tree. However, in certain cases doctors may suggest additional examinations, such as skin viscosity examinations, blood tests, or skin biopsy.

Governance

Pitiriasis rosea can basically heal on its own even without special treatment. Most rashes on pitiriasis rosea will begin to disappear within 6 to 8 weeks, but it can take up to 5 months or more to make the skin look normal again. Stutiriasis rosea management in general can be divided into:

• General governance

While pitiriasis rosea is a self-resistant disease, an important treatment goal is to control itching symptoms, which may be severe enough at 25%. Some of the steps you can take include:

• • Applying moisturizing cream for dry skin.
  • Bath with plain water and use water-based creams, or other soap substitutes.
  • Exposing the skin into the sun carefully (without burning).

• Special management

The following treatment can help treat symptoms and accelerate skin recovery, namely:

• • The medium potential steroid cream/salep and oral antihistamine can reduce itching while waiting for the rash to disappear.
  • For sufferers with severe itching, medication with zinc oxide, lotion kalamin, and even oral steroids (tablets) can help. The use of oral steroid routine is not recommended because there is a risk of recurrence after treatment.
  • Giving a 7-day acylovir can lead to faster rash healing and help relieve itching in severe cases.
  • Extensive cases or settling can be treated with phototherapy (small ultraviolet B therapy)

Complications

In general, rosea pitiriasis rarely causes complications because this condition will basically heal by itself. However, in some cases, pitiriasis rosea can cause a very great itching feeling. If you often scratch the rash too strongly, it is likely to cause a skin wound that can trigger the onset of skin infection. In addition, in patients with white Rosea pitiriasis, dark-lit black spots may appear that will settle even though the rash has healed.

Prevention

There is no definite way to prevent the emergence of Rosea pitiriasis because the cause is not yet known clearly. But you can prevent complications from setting off by not smearing the rash too strongly. 

When Do You Have To Go To A Doctor?

Most cases of pitiriasis rosea can recover on their own even without treatment. However, if symptoms are felt to get heavier or stay more than 3 months, then consult yourself with a doctor.

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