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Pityriasis rosea – evidence for and against an infectious aetiology

Published online by Cambridge University Press:  12 May 2004

A. CHUH ,
H. CHAN  and
V. ZAWAR
A. CHUH
Affiliation:
Department of Medicine, University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong SAR, China
H. CHAN
Affiliation:
Department of Medicine, University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong SAR, China
V. ZAWAR
Affiliation:
Department of Dermatology, NDMVPS Medical College and Research Centre, Nashik, Maharashtra State, India
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Abstract

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Pityriasis rosea, first named as such in 1860, probably holds the longest record for an exanthem suspected to be associated with an infection but for which an exact cause has not been found. The distinctly programmed clinical course, the lack of recurrence for most patients, and the presence of temporal case clustering provide the strongest evidence to support an infectious aetiology. Further support comes from seasonal variation and the association with respiratory tract infections, the unfavourable social and economic background of cases, and a history in some cases of contact with patients with pityriasis rosea. The apparent therapeutic efficacy of several treatment modalities does not provide strong evidence for or against an infectious aetiology. The roles of human herpesvirus 7 and to a lesser extent human herpesvirus 6 remain controversial. There exists reasonable evidence that pityriasis rosea is not associated with cytomegalovirus, Epstein–Barr virus, parvovirus B19, picornavirus, influenza and parainfluenza viruses, Legionella spp., Mycoplasma spp. and Chlamydia spp. infections. Evidence is also unsubstantiated as yet for alternative aetiological hypotheses such as autoimmunity, atopy, and genetic predisposition.

Type
Review Article
Information
Epidemiology & Infection , Volume 132 , Issue 3 , June 2004 , pp. 381 - 390
Copyright
© 2004 Cambridge University Press

Footnotes

Part of this article is based on work submitted by the first author to the University of Hong Kong for the award of the degree of Doctor of Medicine. A complementary paper focusing specifically on the aetiological role of human herpesvirus 7 in pityriasis rosea is to be published in the International Journal of Dermatology.