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Pityriasis Rosea

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161. Lichen Striatus (Overview)

. [ , ] One group of authors has suggested that epigenetic mosaicism may be involved. They hypothesize that lichen striatus is triggered by an immunologic reaction to an infection, which triggers methylation or demethylation of a partially silenced genomic element in predisposed patients. [ ] A report of concurrent pityriasis rosea and lichen striatus may lend support to this theory. Human herpes viruses 6 and 7 have been implicated in the etiology of pityriasis rosea. The concurrent lichen striatus (...) (blaschkitis) following varicella infection. J Eur Acad Dermatol Venereol . 2006 Nov. 20(10):1345-7. . Ishikawa M, Ohashi T, Yamamoto T. Lichen striatus following influenza infection. J Dermatol . 2014 Dec. 41 (12):1133-4. . Verma P, Singal A, Yadav P, Sharma R. Concurrence of lichen striatus and localised pityriasis rosea: Cutaneous mosaicism. Australas J Dermatol . 2013 Feb. 54(1):41-2. . Arias-Santiago SA, Sierra Giron-Prieto M, Fernandez-Pugnarie MA, Naranjo-Sintes R. [Lichen striatus following

2014 eMedicine.com

162. Cutaneous Manifestations of HIV Disease (Overview)

-associated dementia or CNS disease. The immune alterations caused by HIV infection may lead to psoriasis and Reiter syndrome. In some instances, preexisting psoriasis may become more severe with disseminated plaques and pustules. The typical skin lesions of pityriasis rosea may accompany HIV disease. Acquired ichthyosis may begin on the lower extremities and disseminate in advanced HIV disease. Acquired ichthyosis may be a marker of concomitant infection with HIV-1 and human lymphotropic virus II (...) suggest HIV infection. Bournerias et al reported tinea capitis from Microsporum canis in 2 patients infected with HIV. [ ] Pityriasis versicolor may be persistent and recurrent in patients with HIV infection. Previous Next: Deep Fungal Infections Rarely, cutaneous cryptococcosis may be observed in patients with HIV infection. [ ] Clinical manifestations include the following: Cellulitis Papules Plaques Ulcers Translucent dome-shaped papules with central umbilication, resembling MC Cutaneous

2014 eMedicine.com

163. Dermatologic Manifestations of Cardiac Disease (Overview)

Skin manifestations, including nodules (erythema nodosum), may be associated with heart block or cardiomyopathy (see the image below). [ , ] Heart block (second-degree Mobitz type II and third-degree heart block) in a patient with sarcoidosis. Syphilis Aortitis and skin manifestations of secondary often coexist. In secondary syphilis, scattered red-brown papules with thin scaling are noted. The eruption often involves the palms and soles, and it can resemble pityriasis rosea. Associated findings

2014 eMedicine.com

164. Cutaneous Manifestations of HIV Disease (Treatment)

-associated dementia or CNS disease. The immune alterations caused by HIV infection may lead to psoriasis and Reiter syndrome. In some instances, preexisting psoriasis may become more severe with disseminated plaques and pustules. The typical skin lesions of pityriasis rosea may accompany HIV disease. Acquired ichthyosis may begin on the lower extremities and disseminate in advanced HIV disease. Acquired ichthyosis may be a marker of concomitant infection with HIV-1 and human lymphotropic virus II (...) suggest HIV infection. Bournerias et al reported tinea capitis from Microsporum canis in 2 patients infected with HIV. [ ] Pityriasis versicolor may be persistent and recurrent in patients with HIV infection. Previous Next: Deep Fungal Infections Rarely, cutaneous cryptococcosis may be observed in patients with HIV infection. [ ] Clinical manifestations include the following: Cellulitis Papules Plaques Ulcers Translucent dome-shaped papules with central umbilication, resembling MC Cutaneous

2014 eMedicine.com

165. Dermatologic Manifestations of Cardiac Disease (Treatment)

Skin manifestations, including nodules (erythema nodosum), may be associated with heart block or cardiomyopathy (see the image below). [ , ] Heart block (second-degree Mobitz type II and third-degree heart block) in a patient with sarcoidosis. Syphilis Aortitis and skin manifestations of secondary often coexist. In secondary syphilis, scattered red-brown papules with thin scaling are noted. The eruption often involves the palms and soles, and it can resemble pityriasis rosea. Associated findings

2014 eMedicine.com

166. Lichen Striatus (Treatment)

striatus (blaschkitis) following varicella infection. J Eur Acad Dermatol Venereol . 2006 Nov. 20(10):1345-7. . Ishikawa M, Ohashi T, Yamamoto T. Lichen striatus following influenza infection. J Dermatol . 2014 Dec. 41 (12):1133-4. . Verma P, Singal A, Yadav P, Sharma R. Concurrence of lichen striatus and localised pityriasis rosea: Cutaneous mosaicism. Australas J Dermatol . 2013 Feb. 54(1):41-2. . Arias-Santiago SA, Sierra Giron-Prieto M, Fernandez-Pugnarie MA, Naranjo-Sintes R. [Lichen striatus

2014 eMedicine.com

167. Lichen Striatus (Follow-up)

striatus (blaschkitis) following varicella infection. J Eur Acad Dermatol Venereol . 2006 Nov. 20(10):1345-7. . Ishikawa M, Ohashi T, Yamamoto T. Lichen striatus following influenza infection. J Dermatol . 2014 Dec. 41 (12):1133-4. . Verma P, Singal A, Yadav P, Sharma R. Concurrence of lichen striatus and localised pityriasis rosea: Cutaneous mosaicism. Australas J Dermatol . 2013 Feb. 54(1):41-2. . Arias-Santiago SA, Sierra Giron-Prieto M, Fernandez-Pugnarie MA, Naranjo-Sintes R. [Lichen striatus

2014 eMedicine.com

168. Psoriasis, Guttate (Follow-up)

are associated with the clinical types of psoriasis but not with the corresponding lesional psoriasis severity index. Ann Dermatol . 2015 Feb. 27 (1):26-31. . Krishnamurthy K, Walker A, Gropper CA, Hoffman C. To treat or not to treat? Management of guttate psoriasis and pityriasis rosea in patients with evidence of group A Streptococcal infection. J Drugs Dermatol . 2010 Mar. 9(3):241-50. . Mobini N, Toussaint S, Kamino H. Noninfectious erythematous, papular and squamous diseases . 10th ed. Lippincott-Raven

2014 eMedicine.com

169. Dermatologic Manifestations of Cardiac Disease (Follow-up)

Skin manifestations, including nodules (erythema nodosum), may be associated with heart block or cardiomyopathy (see the image below). [ , ] Heart block (second-degree Mobitz type II and third-degree heart block) in a patient with sarcoidosis. Syphilis Aortitis and skin manifestations of secondary often coexist. In secondary syphilis, scattered red-brown papules with thin scaling are noted. The eruption often involves the palms and soles, and it can resemble pityriasis rosea. Associated findings

2014 eMedicine.com

170. Cutaneous Manifestations of HIV Disease (Follow-up)

-associated dementia or CNS disease. The immune alterations caused by HIV infection may lead to psoriasis and Reiter syndrome. In some instances, preexisting psoriasis may become more severe with disseminated plaques and pustules. The typical skin lesions of pityriasis rosea may accompany HIV disease. Acquired ichthyosis may begin on the lower extremities and disseminate in advanced HIV disease. Acquired ichthyosis may be a marker of concomitant infection with HIV-1 and human lymphotropic virus II (...) suggest HIV infection. Bournerias et al reported tinea capitis from Microsporum canis in 2 patients infected with HIV. [ ] Pityriasis versicolor may be persistent and recurrent in patients with HIV infection. Previous Next: Deep Fungal Infections Rarely, cutaneous cryptococcosis may be observed in patients with HIV infection. [ ] Clinical manifestations include the following: Cellulitis Papules Plaques Ulcers Translucent dome-shaped papules with central umbilication, resembling MC Cutaneous

2014 eMedicine.com

171. Human Herpesvirus Type 6 (Follow-up)

(>60 days) ganciclovir prophylaxis. [ ] The antiviral did not affect the prevalence of HHV-6 (67.2%), but HHV-6 viremia appeared later and was of shorter duration among patients on long-term prophylaxis. Because HHV-6 and HHV-7 are possibly associated with pityriasis rosea (PR), it has been suggested that systemic administration of drugs directed against HHV may hasten the recovery of patients who have PR. High-dose acyclovir may be effective for treating PR, especially in patients treated (...) Magalhães-Silverman M. Human herpes virus 6 fatal encephalitis in a bone marrow recipient. Scand J Infect Dis . 1999. 31(3):313-5. . Mendez JC, Dockrell DH, Espy MJ, Smith TF, Wilson JA, Harmsen WS, et al. Human beta-herpesvirus interactions in solid organ transplant recipients. J Infect Dis . 2001 Jan 15. 183(2):179-184. . Broccolo F, Drago F, Careddu AM, Foglieni C, Turbino L, Cocuzza CE, et al. Additional evidence that pityriasis rosea is associated with reactivation of human herpesvirus-6 and -7. J

2014 eMedicine.com

172. Human Herpesvirus 6 (Follow-up)

(>60 days) ganciclovir prophylaxis. [ ] The antiviral did not affect the prevalence of HHV-6 (67.2%), but HHV-6 viremia appeared later and was of shorter duration among patients on long-term prophylaxis. Because HHV-6 and HHV-7 are possibly associated with pityriasis rosea (PR), it has been suggested that systemic administration of drugs directed against HHV may hasten the recovery of patients who have PR. High-dose acyclovir may be effective for treating PR, especially in patients treated (...) Magalhães-Silverman M. Human herpes virus 6 fatal encephalitis in a bone marrow recipient. Scand J Infect Dis . 1999. 31(3):313-5. . Mendez JC, Dockrell DH, Espy MJ, Smith TF, Wilson JA, Harmsen WS, et al. Human beta-herpesvirus interactions in solid organ transplant recipients. J Infect Dis . 2001 Jan 15. 183(2):179-184. . Broccolo F, Drago F, Careddu AM, Foglieni C, Turbino L, Cocuzza CE, et al. Additional evidence that pityriasis rosea is associated with reactivation of human herpesvirus-6 and -7. J

2014 eMedicine.com

173. Gianotti-Crosti Syndrome (Papular Acrodermatitis of Childhood) (Follow-up)

, Williams JV. Gianotti-Crosti syndrome following childhood vaccinations. Pediatr Dermatol . 2013 Jan-Feb. 30(1):137-8. . Baldari U, Monti A, Righini MG. An epidemic of infantile papular acrodermatitis (Gianotti-Crosti syndrome) due to Epstein-Barr virus. Dermatology . 1994. 188(3):203-4. . Chuh A, Zawar V, Sciallis GF, Lee A. The diagnostic criteria of pityriasis rosea and Gianotti-Crosti syndrome - a protocol to establish diagnostic criteria of skin diseases. J R Coll Physicians Edinb . 2015. 45 (3

2014 eMedicine.com

174. Sexuality: Sexual Orientation (Diagnosis)

. Primary syphilis presents as chancres around the anus, pharynx, mouth, and penis. Secondary syphilis presents as a diffuse rash, which may be mistaken for pityriasis rosea. Prior to making a definitive diagnosis of pityriasis rosea, testing for syphilis is especially indicated for any male who is having sex with other males. Herpes simplex I and II manifest as ulcers in the mouth, pharynx, and anus. Anoscopy may demonstrate pus and ulceration. Complications of peritonitis are possible. Genital warts

2014 eMedicine Pediatrics

175. Herpesvirus 6 Infection (Diagnosis)

CE, et al. Additional evidence that pityriasis rosea is associated with reactivation of human herpesvirus-6 and -7. J Invest Dermatol . 2005 Jun. 124(6):1234-40. . Mardivirin L, Valeyrie-Allanore L, Branlant-Redon E, et al. Amoxicillin-induced flare in patients with DRESS (Drug Reaction with Eosinophilia and Systemic Symptoms): report of seven cases and demonstration of a direct effect of amoxicillin on Human Herpesvirus 6 replication in vitro. Eur J Dermatol . 2010 Jan-Feb. 20(1):68-73 (...) excreted in saliva in stem cell transplant recipients. Bone Marrow Transplant . 2007 Apr. 39(8):497-9. . Galarraga MC, Gomez E, de Oña M, Rodriguez A, Laures A, Boga JA, et al. Influence of ganciclovir prophylaxis on citomegalovirus, human herpesvirus 6, and human herpesvirus 7 viremia in renal transplant recipients. Transplant Proc . 2005 Jun. 37(5):2124-6. . Drago F, Vecchio F, Rebora A. Use of high-dose acyclovir in pityriasis rosea. J Am Acad Dermatol . 2006 Jan. 54(1):82-5. . Ohye T, Kawamura Y

2014 eMedicine Pediatrics

176. Herpesvirus 6 Infection (Follow-up)

(>60 days) ganciclovir prophylaxis. [ ] The antiviral did not affect the prevalence of HHV-6 (67.2%), but HHV-6 viremia appeared later and was of shorter duration among patients on long-term prophylaxis. Because HHV-6 and HHV-7 are possibly associated with pityriasis rosea (PR), it has been suggested that systemic administration of drugs directed against HHV may hasten the recovery of patients who have PR. High-dose acyclovir may be effective for treating PR, especially in patients treated (...) Magalhães-Silverman M. Human herpes virus 6 fatal encephalitis in a bone marrow recipient. Scand J Infect Dis . 1999. 31(3):313-5. . Mendez JC, Dockrell DH, Espy MJ, Smith TF, Wilson JA, Harmsen WS, et al. Human beta-herpesvirus interactions in solid organ transplant recipients. J Infect Dis . 2001 Jan 15. 183(2):179-184. . Broccolo F, Drago F, Careddu AM, Foglieni C, Turbino L, Cocuzza CE, et al. Additional evidence that pityriasis rosea is associated with reactivation of human herpesvirus-6 and -7. J

2014 eMedicine Pediatrics

177. Sexuality: Sexual Orientation (Overview)

. Primary syphilis presents as chancres around the anus, pharynx, mouth, and penis. Secondary syphilis presents as a diffuse rash, which may be mistaken for pityriasis rosea. Prior to making a definitive diagnosis of pityriasis rosea, testing for syphilis is especially indicated for any male who is having sex with other males. Herpes simplex I and II manifest as ulcers in the mouth, pharynx, and anus. Anoscopy may demonstrate pus and ulceration. Complications of peritonitis are possible. Genital warts

2014 eMedicine Pediatrics

178. Herpesvirus 6 Infection (Overview)

CE, et al. Additional evidence that pityriasis rosea is associated with reactivation of human herpesvirus-6 and -7. J Invest Dermatol . 2005 Jun. 124(6):1234-40. . Mardivirin L, Valeyrie-Allanore L, Branlant-Redon E, et al. Amoxicillin-induced flare in patients with DRESS (Drug Reaction with Eosinophilia and Systemic Symptoms): report of seven cases and demonstration of a direct effect of amoxicillin on Human Herpesvirus 6 replication in vitro. Eur J Dermatol . 2010 Jan-Feb. 20(1):68-73 (...) excreted in saliva in stem cell transplant recipients. Bone Marrow Transplant . 2007 Apr. 39(8):497-9. . Galarraga MC, Gomez E, de Oña M, Rodriguez A, Laures A, Boga JA, et al. Influence of ganciclovir prophylaxis on citomegalovirus, human herpesvirus 6, and human herpesvirus 7 viremia in renal transplant recipients. Transplant Proc . 2005 Jun. 37(5):2124-6. . Drago F, Vecchio F, Rebora A. Use of high-dose acyclovir in pityriasis rosea. J Am Acad Dermatol . 2006 Jan. 54(1):82-5. . Ohye T, Kawamura Y

2014 eMedicine Pediatrics

179. Gianotti-Crosti Syndrome (Treatment)

Dermatol . 2011 Sep-Oct. 28(5):595-6. . Chuh A, Zawar V, Sciallis GF, Lee A. The diagnostic criteria of pityriasis rosea and Gianotti-Crosti syndrome - a protocol to establish diagnostic criteria of skin diseases. J R Coll Physicians Edinb . 2015 Sep. 45 (3):218-25. . Retrouvey M, Koch LH, Williams JV. Gianotti-Crosti syndrome following childhood vaccinations. Pediatr Dermatol . Jan-Feb 2013. 30(1):137-8. . Media Gallery Multiple erythematous flat-topped papules on the cheeks of an 18-month-old boy

2014 eMedicine Pediatrics

180. Herpesvirus 6 Infection (Treatment)

(>60 days) ganciclovir prophylaxis. [ ] The antiviral did not affect the prevalence of HHV-6 (67.2%), but HHV-6 viremia appeared later and was of shorter duration among patients on long-term prophylaxis. Because HHV-6 and HHV-7 are possibly associated with pityriasis rosea (PR), it has been suggested that systemic administration of drugs directed against HHV may hasten the recovery of patients who have PR. High-dose acyclovir may be effective for treating PR, especially in patients treated (...) Magalhães-Silverman M. Human herpes virus 6 fatal encephalitis in a bone marrow recipient. Scand J Infect Dis . 1999. 31(3):313-5. . Mendez JC, Dockrell DH, Espy MJ, Smith TF, Wilson JA, Harmsen WS, et al. Human beta-herpesvirus interactions in solid organ transplant recipients. J Infect Dis . 2001 Jan 15. 183(2):179-184. . Broccolo F, Drago F, Careddu AM, Foglieni C, Turbino L, Cocuzza CE, et al. Additional evidence that pityriasis rosea is associated with reactivation of human herpesvirus-6 and -7. J

2014 eMedicine Pediatrics

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