Physical examination shows that the rash appears in a Christmas-tree pattern on his chest and back.
The most likely diagnosis is
A) Pityriasis rosea
B) Tinea versicolor
C) Herpes zoster
D) Varicella
E) Lyme disease
The answer is
A. (Pityriasis rosea)
Discussion:
Pityriasis rosea is a common papulosquamous rash that occurs mainly on the trunks of young adults
during the spring and fall. The condition begins with the onset of a “herald patch” that is oval and erythematous. Usually within 2 to 10 days, a generalized rash follows. The individual lesions have fine scaling noted around their edges. In many cases, a Christmas-tree pattern is seen over the
back. The lesions may continue to appear for 2 to 3 weeks. Most cases resolve by 6 to 8 weeks. Pruritus is often present. The disease is not contagious.
Treatment consists of oatmeal colloidal baths, calamine lotion, antihistamines, topical steroids, and ultraviolet-B treatments. Systemic steroids may be necessary for severe cases.
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