Psoriasis or Pityriasis rosea Gibert

The floret lichen or pityriasis rosea gibert is a rash that usually begins with a large, round or oval macula (spot) with raised edges on:

  • Breast
  • Belly
  • Back.

The macula of pityriasis rosea, also called primary medallion or primary spot, can reach a diameter of up to 10 cm.
After about 1-2 weeks, a diffuse rash forms with smaller skin lesions that:

  • have their origin in the centre of the body,
  • spread in a form resembling hanging fir branches.


Types of pityriasis rosea

1. Pityriasis rosea gigantea: Affected are the mouth, nails, genitals and scalp, which are similar to the classic disease.
2. Pityriasis rosea circinata et marginata Vidal: It is characterized by larger red spots that are distant from each other and less numerous. This type can persist for a few months.
3. Vesicular pityriasis rosea: It mainly affects dark-skinned adolescents.
4. Pityriasis rosea urticaria: It occurs together with urticaria.

Where does pityriasis rosea Gibert come from? Causes

Doctors do not know what causes pityriasis rosea.
Some assume that it is an infection caused by the herpes virus type 6 and 7, but science has yet to prove this theory.

People between the ages of 10 and 40 and pregnant women are more likely to develop pityriasis rosea, but it can occur at any age and in all people, regardless of their origin.
The most common disease is in:

  • Spring
  • Autumn.

Symptoms of pityriasis rosea

The symptoms of pityriasis rosea can progress in three distinct stages. However, there is an atypical form of the disease, in which the first or second phase, described below, is absent.

Initial symptoms

Some people with pityriasis rosea show some initial symptoms from a few days to a week before the rash is visible.
Among these are:
1. fever (rare) 2. nausea
3. loss
of appetite 4. headache
5. joint pain (rare) 6. sore throat
7. general malaise
8. enlarged lymph nodes (rare)

These symptoms disappear over time and progress to the phase of rash.

Second phase: thegreat macular

Usually, in the following phase, a red and oval scaly spot appears, which grows for a few days.

At the edge is the spot:

  • well defined,
  • slightly scaly.

In the middle, the skin has:

  • a fine scaling,
  • a color like the rest of the skin.

This rash is called the primary medallion or herald patch.
The macula has a variable size of 2 to 10 cm.
The spot usually appears on:

  • trunk (abdomen, chest and back),
  • Neck.

Rarely, the macula of pityriasis rosea Gibert appears:

  • facial
  • on the scalp,
  • in the genital area.

Third phase: secundary rash

Usually a secondary rash develops:

  • within a few days after the appearance of the round spot,
  • which can spread in the following two to six weeks.

The rash consists of small raised patches, usually between 1 and 2 cm in size.
Most people develop spots on:

  • Trunk
  • Neck
  • Poor
  • Thighs.

The face is usually not affected.

  • In fair-skinned people, the papules are pink.
  • In dark-skinned people, the rash may look gray, brown, or black.

Usually, the papules form a symmetrical structure in the shape:

  • of a Christmas tree on the upper back, in fact, the spots are oblique, like tree branches.
  • a “V” on the chest.

The secondary rash is not painful, but it can cause itching on the skin.
The itching can be mild to strong.
It usually worsens in:

Could pityriasis rosea be caused by a viral infection?

According to recent studies, the cause of the condition could be a viral infection.
Recently, the virus could be assigned to the family of herpes viruses.
Children and adolescents are much more vulnerable for unknown reasons.
Pityriasis rosea does not appear to be contagious, but family members should practice stricter personal hygiene to be safe.

How is the diagnosis of pityriasis rosea made?

The doctor makes the diagnosis of pityriasis rosea by looking at the rash.
The diagnosis can be difficult if you only see a large macula, because often the disease is confused with tinea or eczema at this stage.
In differential diagnosis, the doctor must also exclude the following diseases:

After the appearance of the rash, the diagnosis is easy to make.
skin biopsy is only performed in the case of persistent pityriasis rosea, i.e. if it does not pass again.

Treatment of pityriasis rosea Gibert

Since pityriasis rosea Gibert heals independently in two to twelve weeks after its occurrence, no therapy is needed if severe itching is not added.

There are three basic treatment options:

  • Emollients – skin creams that retain skin moisture
  • Local corticosteroids – cortisone-containing creams and ointments
  • Antihistamines – a very common drug used to treat symptoms of allergy, for example, itching

If this is not successful, the patient can be referred to a dermatologist (specialist in skin diseases) who can recommend a treatment called phototherapy with ultraviolet light (UVB).

Emollients are creams, ointments and lotions that help keep the skin moist and relieve itching.
You can apply the properties of an emollient for itching. Apply the cream carefully and avoid strong rubbing on the skin.
Some plasticizers:

  • were developed as soap substitutes,
  • are usually recommended because regular soap can irritate skin rash.

These types of plasticizers are available over the counter.

Local cortisones
If plasticizers can not relieve itching, a conversation with the doctor is recommended.
Additional therapies with topical corticosteroids may help.
Cortisone, which is applied directly to the skin as an ointment or cream, comes in two types:
1. hydrocortisone cream,
2. betamethasone.

The main objective of topical cortisone application is:

  • reduction of inflammation (redness of the skin),
  • Relief of itching.

It is generally recommended to apply the cream or cortisone-containing ointment once or twice a day to the affected areas of the skin.
If the cortisone ointment is applied according to the doctor’s instructions, side effects of cortisone are rare.
Some people may experience a slight burning sensation on the skin or a stinging sensation the first time they apply the cream.
This secondary effect is temporary and should pass once the organism gets used to the drug.

If you can’t sleep because of the itching, the doctor may prescribe an antihistamine such as:

  • hydroxyzine (Atarax),
  • Chlorphenamine (Balkis cold capsules).

Antihistamines are medications prescribed for allergies such as allergic rhinitis (hay fever), but among the side effects, drowsiness occurs in many patients.

  • Usually, the drug must be taken just before bedtime.
  • Many people feel very sleepy the following morning.

In such a case, it is not allowed to drive a car or drive machines.

Treatment of pityriasis rosea with ultraviolet rays (UVB)

If the symptoms do not respond to the treatments mentioned above, the doctor may recommend phototherapy with ultraviolet rays (UVB).
In this treatment, from a few seconds to several minutes, the skin is exposed to controlled ultraviolet radiation under the guidance of a specialist.
It is not the same as a tanning bed.
However, there are some doubts about the effectiveness of UVB radiation therapy for pityriasis rosea.

  • Some medical studies show that itching can be reduced;
  • others indicate that only the external aspect of the rash is improved in the first weeks of the disease.

According to some doctors, therapy with UVB rays can cause spots on the skin even after healing.
Some individuals believe that natural sun exposure to the skin over short periods of time can be beneficial.
You just have to be careful not to stay too long in the sun, because an extended stay:

  • damage the skin,
  • may increase the risk of melanoma development.

Other therapies and pharmaceuticals for pityriasis rosea

Various treatments and pharmaceuticals are available for pityriasis rosea, but there are doubts about their effectiveness.
Among these are:

  • Acyclovir is an antiviral drug used to treat herpetic infections
  • Erythromycin is an antibiotic used to treat bacterial infections
  • Oral cortisones (tablets)

One must be aware that there is little scientific evidence about the effectiveness and safety of these drugs in the case of pityriasis rosea.

Natural remedies for pityriasis rosea

These steps may be helpful to relieve the discomfort of pityriasis rosea:
1. Wash in lukewarm water.
2. Take a bath in a tub with oatmeal or baking powder.
Oatmeal is available in a pharmacy.
3. Apply a soothing lotion to the rash.
4. Apply aloe vera gel to the stains.
5. Apply a paste or cream with zinc oxide to reduce the size of the spots and itching.
6. Eat a healthy diet without fried foods, red meat, dairy and coffee.

How long does pityriasis rosea last? Can she come back?

The rashes are not contagious.
In most cases, the time for healing the large macula and rash is about twelve weeks.
After the rash disappears, some dark or light spots may be noticed on the skin.
Within a few months, however, everything would have to return to normal.
Pityriasis rosea leaves no scars.
If the pityriasis rosea has passed, usually no white spots or other traces remain.
Recurrences are rare – in a person with this disease, there is only two percent chance of developing it again.

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