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December 1991

Picture of the Month

Author Affiliations

Contributed from the Department of Pediatrics, School of Medicine, University of Pennsylvania, Philadelphia.

Am J Dis Child. 1991;145(12):1441-1442. doi:10.1001/archpedi.1991.02160120109030

Denouement and Discussion 

Manifestations  Pityriasis rosea (PR) commonly occurs in children and young adults. The classic appearance, ovoid plaques arranged with their long axes following skin cleavage lines, creating a pine-bough or fir-tree configuration, is easily recognized by most physicians. The rash of this disorder is much more variable than most suspect, resulting in missed diagnoses, unnecessary laboratory tests, and referral to dermatologists. The figures illustrate the typical lesions and some of the variability seen with this common eruption.The label applied to dermatologie disorders often describes the clinical picture. Pityriasis means a fine scale and rosea means pink. The rash, then, is characterized by pink lesions with fine scales. The lesions of pityriasis rosea occur most commonly on the trunk. A single lesion, the herald patch, may precede the appearance of the secondary rash by 7 to 14 days. The patch occurs most frequently on the trunk and may be as large as 10 cm in diameter. Its prevalence is varied, but it probably precedes

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