PEDIATRICSTREATMENT
Generally no treatment is indicated because the lesions are self-limited and
resolve without scarring.
Pityriasis Rosea
■ Etiology is unknown, but possibly a viral agent (human herpes virus: HHV-7).
■ Highest incidence is in adolescents.
SYMPTOMS/EXAM
■ Herald patchprecedes other symptoms in 50% of patients. The herald
patch is a scaly, erythematous, oval lesion typically on the torso.
■ 1–2 weeks after appearance of herald patch there is a development of general-
ized rash, with oval, pink macules aligned along the skin dermatomes of the
torso (“Christmas tree” distribution; see Figure 5.6).
■ Typically, palms and soles are spared.
■ Rash may last up to several months.
DIFFERENTIAL
■ 2° syphilis (especially if palms and soles are involved)
■ Acute drug reaction
■ Reaction to recent immunization
■ Herald patch may resemble tinea corporis.
DIAGNOSIS
Clinical diagnosis
TREATMENT
■ No treatment is known to shorten length of rash.
■ Symptomatic treatment for pruritis: Skin moisturizers, oral antihistamines,
possibly topical steroids
FIGURE 5.5. Molluscum contagiosum.
(Reproduced, with permission, from Shah BR, Lucchesi M. Atlas of Pediatric Emergency
Medicine. New York: McGraw-Hill, 2006:342.)