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Herald Patch as the Only Evidence of Pityriasis Rosea: Clinical, Laboratory and Pathogenetic Features
Francesco Drago1, Astrid Herzum2, Serena Varesano3
1Dermatology Clinic, Villa Montallegro Health Clinic, Via Monte Zovetto 27, 16145 Genoa, Italy.
Viruses
|January 25, 2025
Summary
Pityriasis rosea (PR) can present as a rare abortive form, with only a herald patch appearing. This variant shows shorter duration and lower human herpesvirus (HHV)-6/7 DNA levels compared to classic PR.
Area of Science:
- Dermatology
- Virology
- Immunology
Background:
- Pityriasis rosea (PR) is a common skin rash linked to human herpesvirus (HHV)-6 and HHV-7 reactivation.
- Typically, PR starts with a herald patch, followed by a widespread rash, but a rare variant presents only the herald patch.
Purpose of the Study:
- To investigate the clinical and laboratory characteristics of Pityriasis rosea presenting solely with a herald patch.
- To compare this rare variant with the classic presentation of Pityriasis rosea.
Main Methods:
- An observational, retrospective study comparing 19 patients with herald patch-only PR to 19 age- and sex-matched controls with classic PR.
- Data were extracted from a Pityriasis rosea registry spanning 2003-2023.
Main Results:
- Patients with the herald patch-only variant had a shorter exanthem duration.
- Lower mean plasma loads of human herpesvirus (HHV)-6 and HHV-7 DNA were observed in the herald patch-only group compared to controls.
Conclusions:
- The herald patch-only presentation may represent an abortive form of Pityriasis rosea.
- This variant might occur when a robust immune response controls HHV-6/7 reactivation more effectively than in classic PR.
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