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It's just the pits!

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Tuesday, September 27, 2011

It's just the pits!

Sometimes there are viruses that "normally" people get as children or young adolescents, but for some reason adults haven't been exposed and then get a childhood virus as adults.  For many reasons this can seem a little creepy, and mainly because you may all of a sudden have symptoms from something that isn't a big deal, but because you are an adult, you might think you have some horrible form of advanced cancer....or maybe that's just me?

One virus that I actually got when I was in my early 20's was pityriasis rosea, and there have been a few cases of people I know getting diagnosed within the past year or so, as adults, and it can be kind of creepy.  It is a virus with a skin rash component, but some of the lesions can look like secondary syphilis, which can really throw your HCP for a loop!

What is Pityriasis rosea?
It is a virus that can last for about 6 weeks, and for most people it starts with an upper respiratory infection (like a little irritating cough that lasts 7-10 days).  After the cough goes away, you can get a "herald" patch (one large area of scaly skin- the first patch) on your abdomen, that can be hidden in a skin fold, armpit, or somewhere else where it may be difficult to see; it can come and go with no other symptoms.  Approximately 10 days after the herald lesion leaves, there is a rash of small lesions that are usually found on the back and travel along the rib bones, in a Christmas tree shape.  The rash can be really itchy, or not at all.  It can also cause headaches, exhaustion, and a general sense of feeling crappy.  Technically, it isn't contagious but, it has been known to infect people who spend a lot of time together (i.e. dorms, daycare, military barracks, etc.)



How is it diagnosed?
Usually it is diagnosed on clinical presentation (if you have had an upper respiratory infection recently, and based on the presentation of the rash).  If your symptoms are more generalized or you don't remember having a cough/cold recently, your HCP may take a scraping of the rash to rule out psoriasis and ringworm, take some blood to rule out syphilis, and if the rash is really severe they make take a biopsy (which would be VERY aggressive.)  If you have recently started a new medication, you also need to rule out that it is an allergic reaction.

What is the treatment?
The treatment is pretty simple actually, because it is a virus, so no medications will make it go away.  You can take oral antihistamines if the itching is bothering you, or use antihistamine creams/gels to prevent the itching symptoms.  For headaches and discomfort, you can take acetaminophen (paracetamol), or ibuprofen.  However, direct sunlight has been shown shorten the time that the lesions are apparent, you still may feel unwell, but the skin rash will leave sooner.  This is one of the only times that I will ever tell you that UV therapy in a tanning bed might actually be good for you, but one session in a tanning bed usually clears up the rash completely!

I am always really in tune to skin rashes, I tend to freak out with rashes (all other symptoms of viruses never seem to bother me) and I am not sure why, but if you do have a cold that seems to linger, and a rash directly after, especially if it has that christmas tree shape, most likely you have Pityriasis rosea and OTC medication and a trip to the tanning bed (just ONE!) should clear up your rash and start to make you feel better!  But, it is best to go see your HCP in case you have one of the other viruses/processes that mimic Pityriasis rosea.

Yours in Good Health,
B

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