Atypical presentations of pityriasis rosea: a reply

Pityriasis rosea (PR) may have atypical presentations as regards morphology and distribution of the lesions. Recently, several forms of PR considered atypical for the course of the disease have been described. Differently from the typical PR that resolves within 2-12 weeks, relapsing and persistent PR forms (lasting longer than 12 weeks) have been described in adults and children. Lesions of the oral mucosa in PR may be more common than as reported in the literature. Formerly, the occurrence of oral lesions in PR has been considered more frequent in dark-skinned patients compared to light-skinned patients. However, in 12 Caucasian adult patients with persistent PR that have been recently described, oral lesions were very common (75% of cases). Another study on the clinical features and virological parameters of 31 Caucasian children with PR showed that painless oropharyngeal lesions were present in 35% of them, a rate much higher than those reported in adult dark-skinned (9%) and Caucasian patients (16%) with typical PR.