Improvement of rash and itching was reported for 50 percent of the treated sides. In a 1983 study, 23 20 patients were treated unilaterally (one half of each patient's body served as the treatment side and the other half was left untreated) five times daily. Ultraviolet radiation, through artificial sources or intentional exposure to natural sunlight, has been recommended to decrease the duration of rash and intensity of itching in patients with pityriasis rosea. Topical or systemic steroids and antihistamines often are used to relieve itching. Resolution of the rash may be hastened by ultraviolet light therapy but not without the risk of hyperpigmentation. One small controlled trial reported faster clearing of the exanthem with the use of erythromycin, but the mechanism of effect is unknown. Several medications can cause a rash similar to pityriasis rosea, and several diseases, including secondary syphilis, are included in the differential diagnosis. Pityriasis rosea is difficult to identify until the appearance of characteristic smaller secondary lesions that follow Langer's lines (cleavage lines). The herald patch often is misdiagnosed as eczema. It is characterized by an initial herald patch, followed by the development of a diffuse papulosquamous rash. Pityriasis rosea typically affects children and young adults. Viral and bacterial causes have been sought, but convincing answers have not yet been found. The risk appears to be greatest in women who have more extreme cases of the disorder.Pityriasis rosea is a common, acute exanthem of uncertain etiology. There is evidence of a higher rate of miscarriage, premature birth and certain birth abnormalities in women who develop the disease at this time, possibly because a virus responsible for the rash damages the fetus. Pityriasis rosea can be serious when it occurs in pregnant women, particularly those in the early stages of pregnancy. Occasionally, patients are left with dark patches of skin but these normally disappear over time. Ordinarily, pityriasis rosea is not a dangerous condition and the rash leaves no residual damage, though if the patient develops a severe, pustular rash, there is potential danger of infection. If the symptoms of pityriasis rosea are particularly harsh, oral corticosteroids may be temporarily prescribed. Limited exposure to sun or phototherapy may also be helpful. Cool compresses, restricted use of soap or perfumed lotion, and the wearing of soft clothing may provide relief. Treatments for pityriasis rosea consist of the usual remedies for itching and rashes, such as colloidal oatmeal baths, steroid creams and antihistamines.
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