Pityriasis Rosea-Like Eruption following anti-fatigue traditional herbs: Aconitum carmichaelii Debx and Panax Ginseng suspected.

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.

Utility of IL-36 immunostaining in distinguishing psoriasis from pityriasis rosea and pityriasis lichenoides.

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.

An atypical form of pediatric pityriasis rosea of the diaper area: Pityriasis marginata et circinata of Vidal.

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.

Atypical plaque psoriasis: a clinicopathological study of 20 cases.

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.

Pityriasis rosea: dermoscopic features in Uganda.

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.

Pityriasis Rosea in Kaduna, North-West Nigeria: A 20-Year Experience.

BACKGROUND: Pityriasis rosea (PR) is an acute, self-limiting papulosquamous skin disease which predominantly affects children and young adults. Pityriasis rosea appears to be more common in West Africa. Reports about PR from northern Nigeria are few. OBJECTIVES: To present the relative prevalence, demographic and clinical characteristics of PR. METHODS: We conducted a retrospective review of records of consecutive patients attending two dermatology clinics in Kaduna, North-West Nigeria between September 2001 and November 2021. RESULTS: Of 39,037 patients, 922 (2.4%) presented with PR: Median age was 15 years (range 3 months to 63 years) and 24% < 10 years, 60% < 18 years, 87% < 30% years. 62% were female. In patients < 20 years, males were significantly more in number than females (69.6% vs. 60.9%, P = 0.007) while in those >20 years, females were more in number (39.1% vs. 30.4%, P = 0.007). The mean duration of disease at presentation was 14 days (range 1 - 240 days). Majority (60%) were seen during the rainy season. A herald patch was present in 67.8%, usually occurring 7 days before the main rash. The trunk was affected by the main rash in 94% while the neck and face were affected in 19.2% and 23.6%, respectively. Itching was reported by 80%. The classic disease constituted 80.2%. Oral involvement was rare. CONCLUSION: Pityriasis rosea is a common disease in Kaduna. It mostly affects children, adolescents and young adults. Clinical presentation is typical in the majority of patients. Rarely an atypical disease occurs. Oral involvement was rare.

CONTEXTE: Le pityriasis rosé (PR) est une dermatose papulosquameuse aiguë spontanément résolutive qui touche principalement les enfants et les jeunes adultes. Le pityriasis rosea semble être plus courant en Afrique de l'Ouest. Les rapports sur la RP du nord du Nigeria sont peu nombreux. OBJECTIFS: Présenter la prévalence relative, les caractéristiques démographiques et cliniques de la RP. METHODES: Nous avons effectué un examen rétrospectif des dossiers de patients consécutifs fréquentant deux cliniques de dermatologie à Kaduna, dans le nord-ouest du Nigeria, entre septembre 2001 et novembre 2021. RESULTATS: Sur 39 037 patients, 922 (2,4 %) ont présenté une RP : l'âge médian était de 15 ans (intervalle de 3 mois à 63 ans) et 24 % < 10 ans, 60 % < 18 ans, 87 % < 30 % ans. 62 % étaient des femmes. Chez les patients de < 20 ans, les hommes étaient significativement plus nombreux que les femmes (69,6 % contre 60,9 %, P = 0,007) tandis que chez ceux de > 20 ans, les femmes étaient plus nombreuses (39,1 % contre 30,4 %, P = 0,007) . La durée moyenne de la maladie au moment de la présentation était de 14 jours (fourchette de 1 à 240 jours). La majorité (60%) ont été observées pendant la saison des pluies. Un patch annonciateur était présent chez 67,8%, survenant généralement 7 jours avant l'éruption principale. Le tronc était touché par l'éruption principale dans 94 % tandis que le cou et le visage étaient touchés dans 19,2 % et 23,6 %, respectivement. Des démangeaisons ont été signalées par 80 %. La maladie classique constituait 80,2 %. L'atteinte orale était rare. CONCLUSION: Le pityriasis rosé est une maladie courante à Kaduna. Elle touche principalement les enfants, les adolescents et les jeunes adultes. La présentation clinique est typique chez la majorité des patients. Rarement une maladie atypique survient. L'atteinte orale était rare. Mots clés: Pityriasis rosé, Kaduna-Nigeria, Épidémiologie, Présentation clinique, Africains.

Manifestation of pityriasis rosea and pityriasis rosea-like eruptions after Covid-19 vaccine: A systematic review.

BACKGROUND: After introducing Covid-19 vaccines, a few side effects were reported, pityriasis rosea being one of them. Therefore, this study will systematically review its manifestation afteradministration. METHODS: Databases were searched, covering a timeline from December 1, 2019 to February 28, 2022. Data were independently extracted and accessed for bias. SPSS statistical software version 25 was used for appropriate inferential statistics. RESULTS: Thirty-one studies were included for data extraction after screening following the eligibility criteria. A total of 111 people were identified to have developed pityriasis rosea or pityriasis rosea-like eruptions after vaccination, out of which 36 (55.38%) were female. The average age of incidence was calculated to be 44.92 years, and 63 (62.37%) people presented after administration of the first dose. It was found popularly in the trunk area, either asymptomatically or with mild symptoms. Meantime the onset, was 8.58 days, and meantime it took to recover, was 6.44 weeks. CONCLUSION: The association between pityriasis rosea and pityriasis rosea-like eruptions after Covid-19 vaccines was established, but given the scarcity of studies, there is a need to conduct different clinical trials to confirm this association further and study the etiology and mechanism of the disease.

Cutaneous reactions after COVID-19 vaccination in Turkey: A multicenter study.

OBJECTIVES: In this study covering all of Turkey, we aimed to define cutaneous and systemic adverse reactions in our patient population after COVID-19 vaccination with the Sinovac/CoronaVac (inactivated SARS-CoV-2) and Pfizer/BioNTech (BNT162b2) vaccines. METHODS: This prospective, cross-sectional study included individuals presenting to the dermatology or emergency outpatient clinics of a total of 19 centers after having been vaccinated with the COVID-19 vaccines. Systemic, local injection site, and non-local cutaneous reactions after vaccination were identified, and their rates were determined. RESULTS: Of the 2290 individuals vaccinated between April 15 and July 15, 2021, 2097 (91.6%) received the CoronaVac vaccine and 183 (8%) BioNTech. Systemic reactions were observed at a rate of 31.0% after the first CoronaVac dose, 31.1% after the second CoronaVac dose, 46.4% after the first BioNTech dose, and 46.2% after the second BioNTech dose. Local injection site reactions were detected at a rate of 35.6% after the first CoronaVac dose, 35.7% after the second CoronaVac dose, 86.9% after the first BioNTech dose, and 94.1% after the second BioNTech dose. A total of 133 non-local cutaneous reactions were identified after the CoronaVac vaccine (2.9% after the first dose and 3.5% after the second dose), with the most common being urticaria/angioedema, pityriasis rosea, herpes zoster, and maculopapular rash. After BioNTech, 39 non-local cutaneous reactions were observed to have developed (24.8% after the first dose and 5% after the second dose), and the most common were herpes zoster, delayed large local reaction, pityriasis rosea, and urticaria/angioedema in order of frequency. Existing autoimmune diseases were triggered in 2.1% of the patients vaccinated with CoronaVac and 8.2% of those vaccinated with BioNTech. CONCLUSIONS: There are no comprehensive data on cutaneous adverse reactions specific to the CoronaVac vaccine. We determined the frequency of adverse reactions from the dermatologist's point of view after CoronaVac and BioNTech vaccination and identified a wide spectrum of non-local cutaneous reactions. Our data show that CoronaVac is associated with less harmful reactions while BioNTech may result in more serious reactions, such as herpes zoster, anaphylaxis, and triggering of autoimmunity. However, most of these reactions were self-limiting or required little therapeutic intervention.

Impact of COVID-19 on Clinicopathological Spectrum of Pityriasis Rosea in Korea.

BACKGROUND: Pityriasis rosea (PR) is a papulosquamous eruption with generally unknown origin but suspected to be related to viral etiologies. The clinicopathological spectrum of several disorders with viral etiologies has been altered after the coronavirus disease 2019 (COVID-19) pandemic. The author group could experience coherent histological alterations in PR after the COVID-19 pandemic. This study aimed to investigate how the clinicopathological findings of PR were changed after the COVID-19 pandemic. METHODS: Patients (n = 11) diagnosed with PR based on the clinical manifestations and skin biopsies between February 2018 and October 2019 and 11 patients in February 2020 and October 2021 were retrospectively analyzed by investigating the medical records. RESULTS: The patients with PR during the COVID-19 pandemic demonstrated statistically significant histopathological alterations from classic brisk and dense infiltration pattern to dormant and sparse infiltration and psoriasiform-dominant patterns (P = 0.019). PR was associated with more frequent pruritus during the pandemic period (P = 0.027). CONCLUSION: In conclusion, PR demonstrated a significant histopathological alteration with more frequent pruritus during the COVID-19 pandemic. The comparative results about clinicopathological findings of PR will provide a useful reference for dermatologists in the diagnostic process of PR in the COVID-19 pandemic.

Molecular study of recent virus and its relationship to Pityriasis rosea.

BACKGROUND: A new type of coronavirus family severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) that has been detected in individuals with several clinical symptoms named COVID-19, was recognized as a pandemic on March 11, 2020. Numerous researches have been conducted on the manifestations of a skin disease related to COVID-19, i.e., rashes or Pityriasis rosea (PR), vascular markings, and pimple-like lesions. AIM: This study aims to find out if the Coronavirus can affect the PR development, which also can be considered as a trigger and symptom for other types of infections. MATERIAL AND METHODS: This study is a case series describing the dermatological findings related to COVID-19 in the Thi-Qar Governorate. Samples were taken from inpatients, outpatients, and from the emergency unit of Al Hussein Teaching Hospital, and inwards of Al-Shefaa' Isolation Hospital. The study has been done over a 4 month period (June-September, 2020.). RESULTS: Around 19 patients, 10 females (52.6%) and 9 males (47.4%), who were infected with Coronavirus and were suffering from PR, are included in this study. The distribution of patients according to the incidence of PR in typical and anomalous manners were 77.9% and 21.1% respectively. The highest percentage of the incidence of PR was in moderate COVID-19 (84.2%), while it was around 15.8% in mild COVID-19. There was no significant statistical difference in the mean age distribution according to gender, while there was a significant statistical difference according to PR and COVID-19 class. More studies are needed to evaluate whether or not these lesions are associated with the virus. CONCLUSION: The PR was one of the dermatological finding of COVID-19 that did not have a clear role in the distribution of the disease according to the background of the patients, and also the severity of COVID-19. It can be triggered by COVID-19 and be completely cured with the clearance of the disease. RECOMMENDATION: An accurate robust cutaneous documentation related to COVID-19 is required to improve the knowledge of the disease as well as its epidemiology.