Atypical pityriasis rosea and Hodgkin's disease.

Pityriasis rosea (PR)-like eruptions have been associated with several neoplasms and drugs. These eruptions may be atypical. To date, the association of Hodgkin's disease with PR-like eruptions has rarely been reported. We report a 37-year-old patient with clinical lesions of PR-like, systemic symptoms and lymphadenopathies, who was subsequently diagnosed with Hodgkin's disease.     

非索非那定联合UVB治疗玫瑰糠疹疗效观察

目的:评价非索非那定联合中波紫外线照射治疗玫瑰糠疹的疗效。方法:将58例患者随机分为两组,治疗组30例口服非索非那定60 mg,2次/d,同时照射中波紫外线,隔日1次,连续10次。对照组28例口服非索非那定60 mg,2次/d,20天后观察疗效。结果:治疗组总有效率为96.6%,对照组为64.2%,二者差异有显著性(P0.01)。结论:非索非那定联合紫外线治疗玫瑰糠疹疗效好。     

玫瑰疹病毒属与玫瑰糠疹发病的相关性研究现况

玫瑰糠疹是一种病因尚未明确的炎症性、自限性红斑鳞屑性皮肤病,至今病因尚未明确。近年来,关于玫瑰糠疹与玫瑰疹病毒属人疱疹病毒6、7型的研究较为深入,本文对相关文献进行了综述。     

不典型玫瑰糠疹40例分析

玫瑰糠疹是一种比较常见的皮肤病，典型病例的表现具有特征性，比较容易诊断，但是少数病例临床表现不典型，容易误诊为湿疹，皮炎，多形性红斑，二期梅毒疹等多种皮肤病。本文对４０例资料较完整，临床表现不典型的玫瑰糖疹进行分析，并提出诊断依据。     

Correlation between HLA and pityriasis rosea susceptibility in Brazilian blacks

Objectives The human leucocyte antigen (HLA) has been related to susceptibility factors in several diseases. This study aimed to determine the potential genetic susceptibility of patients with pityriasis rosea (PR) through HLA molecular typing analysis. Methods The method of choice was polymerase chain reaction with sequence‐specific primers (PCR‐SSP) using low‐resolution typing kits, with determination of the alleles class I (HLA‐A, HLA‐B and HLA‐C) and class II (HLA‐DRB1, DRB3, DRB4, DRB5 and DQB1) performed in 30 Afro‐Brazilian PR‐diagnosed patients and 45 healthy individuals as the control group (PR‐C). Results Analysis of the HLA typing results showed that the relative risk (RR) of 4.00 [95% confidence interval (95% CI) 1.20–13.28, two‐tailed P = 0.018] for allele HLA‐DQB1*04 class II, detected in 33.3% of PR patients, was significant. By contrast, in the control group only 11.1% of subjects had that allele. Three out of six B*51 alleles and three out of six B*53 alleles detected in PR patients were found, together with the allele DQB1*04. Conclusion We suggest that alleles DQB1*04 may be involved in the genetic susceptibility of PR based on the significant predominance of those alleles observed in the black PR patients. We also recommend that more studies are conducted on populations of other ethnic origins, preferentially with higher resolution techniques of DNA typing.     

Concurrence of lichen striatus and localised pityriasis rosea: Cutaneous mosaicism

Cutaneous mosaicism has always been an intriguing subject. A 15‐year‐old boy presented to us with a unilateral band of lesions of pityriasis rosea and lichen striatus. The case is discussed in the light of the concept of genetic mosaicism.     

Geographic tonguelike presentation in a child with pityriasis rosea: Case report and review of oral manifestations of pityriasis rosea

Oral lesions are rarely reported in patients with pityriasis rosea. We report a case of a 3‐year‐old boy with clinical evidence of generalized pityriasis rosea who developed asymptomatic oral lesions similar in appearance to geographic tongue. The generalized eruption and tongue lesions resolved simultaneously within 4 weeks. We also review the literature on the oral manifestations of Pityriasis rosea.     

中药煎剂治疗玫瑰糠疹48例疗效观察

目的观察中药煎剂治疗玫瑰糠疹的疗效。方法将78例玫瑰糠疹患者随机分为两组，治疗组48例服用自拟中药方治疔，对照组30例口服西可韦（西替立嗪）、维生素c治疗。结果治疗组服药7天和14天后总有效率分别为60．4％和93．8％，对照组为20％和53．3％，两组差异有显著性意义（P〈0．01）。结论中药煎剂治疗玫瑰糠疹疗效优于常规西医治疗。     

玫瑰糠疹患者外周血IL-17和IL-22的表达

目的：检测外周血IL-17和IL-22在玫瑰糠疹患者中的水平。方法：采取酶联免疫(ELISA)双抗体夹心法,检测45例玫瑰糠疹急性期患者、45例恢复期患者和45名健康人外周血中IL-17和IL-22的水平。结果：玫瑰糠疹急性期、恢复期患者与正常对照组外周血IL-17浓度分别为45.08±14.34 pg/mL,29.34±11.88 pg/mL,15.51±8.79 pg/mL;IL-22浓度分别为85.43±20.01 pg/mL,61.26±10.37 pg/mL,50.54±13.28 pg/mL。三组IL-17和IL-22水平比较差异有统计学意义(P＜0.05)。结论：玫瑰糠疹急性期及恢复期患者均存在IL-17和IL-22的表达异常,该疾病可能存在Th17细胞亚群失衡。     

玫瑰糠疹表皮内血管细胞黏附分子1和细胞间黏附分子1的表达

目的:研究血管细胞黏附分子(1VCAM-l)和细胞间黏附分子(1ICAM-1)在玫瑰糠疹发病中的作用。方法:采用链酶卵白素-过氧化物酶法检测表皮内VCAM-l、ICAM-1的表达。结果:VCAM-1在玫瑰糠疹皮损表皮基底层、棘层表达高于皮损周围正常皮肤及正常人皮肤,在皮损周围正常皮肤棘层表达高于正常人皮肤。ICAM-1在皮损、皮损周围正常皮肤基底层的表达高于正常人皮肤,在皮损棘层的表达高于皮损周围正常皮肤及正常人皮肤。结论:玫瑰糠疹表皮VCAM-1、ICAM-1的高表达可能与玫瑰糠疹的发病机制有关。     

Low dose of acyclovir may be an effective treatment against pityriasis rosea: a random investigator‐blind clinical trial on 64 patients

Background Pityriasis rosea (PR) is a papulosquamous disease with an unknown aetiology, but recently the role of two herpes viruses human herpes virus 6 and human herpes virus 7 was defined as being the aetiology of PR. Objective The aim of this study was to compare a low dose (400 mg five times a day for a week) anti‐viral agent, acyclovir, with follow‐up protocol for the treatment of PR. Methods A randomized, investigator‐blind, prospective, 4‐week study was designed. Sixty‐four patients with PR presenting at the outpatient clinic were randomly allocated to acyclovir (400 mg five times a day for 1 week) or follow‐up group. Fifty‐four of them completed the period of study and their clinical responses such as improvement rate of erythema, and scaling and occurrence of complications were evaluated by two dermatologists using weekly photographic records. Results Statistically, acyclovir was more effective than follow‐up in reducing erythema at the end of the first, second, third and fourth week of treatment. Although the decrease in scaling was higher in the acyclovir group at the end of the first, second and third week of treatment, there was no statistical significance between two groups at the end of fourth week of treatment in the both groups. Conclusions According to our study, acyclovir may be more effective than follow‐up in reducing erythema and shortening of duration of PR even in lower doses than was applied in previous studies. So given the safety of acyclovir, we suggest to our colleagues to consider this treatment when facing a patient suffering from this conundrum, at least in extensive or having pruritus ones.     

Epidemiological study of human herpesvirus-6 and human herpesvirus-7 in pityriasis rosea

BACKGROUND: Pityriasis rosea (PR) is a common papulosquamous skin disorder that is suspected to have an infectious aetiology. OBJECTIVES: We aimed to study the role of human herpesvirus (HHV)-7 and HHV-6 in the pathogenesis of PR. METHODS: We performed seroepidemiological studies (indirect immunofluorescence test) and polymerase chain reaction (PCR) analysis for HHV-6 and HHV-7 in patients with PR. Seventy-two serum samples and 37 samples of peripheral blood mononuclear cells (PBMC) from 44 patients with PR were obtained. Twenty-five patients with other skin disorders such as drug eruption, urticaria or herpes zoster were studied as controls in the PCR analysis. RESULTS: HHV-7 DNA was detected in 13 of 30 (43%) samples of PBMC of the patients with PR and 14 of 25 (56%) samples of PBMC of controls. HHV-6 DNA was detected in six of 29 (21%) patients with PR and nine of 23 (39%) controls. Thus there was no difference in the prevalence of HHV-6 or HHV-7 in PBMC between patients with PR and those with other skin disorders. In the seroepidemiological study, two cases of at least a fourfold rise in titre and five cases of a fourfold decrease in titre to HHV-7 antibody, and two cases of a fourfold rise in titre and two cases of a fourfold decrease in titre to HHV-6 antibody, were observed in 24 patients with PR. This seroepidemiological study revealed antibody responses consistent with active infection in several PR patients, but the greater proportion of the patients had no definite increase in the antibody titres. CONCLUSIONS: We conclude that HHV-7 and HHV-6 may play a part in some patients with PR, but that other causative agents may exist. Further analyses are needed to determine the causative agents of PR.     

L‐lysine therapy to control the clinical evolution of pityriasis rosea: Clinical case report and literature review

Pityriasis rosea (PR) is a dermatological disease with an erythemato‐papulosquamous manifestation, distributed on the trunk and extremities affecting healthy people, especially children and young people between 10 and 35 years of age. The evolution is 6 to 8 weeks and may remain for 3 to 6 months. It regresses spontaneously and can leave changes in the skin color but reversibly. Acyclovir is indicated to minimize clinical manifestations with the suspected of viral association (HHV‐6 and 7). Another group of the human herpesvirus family (HHV‐1 and 2), causes herpes simplex that is controlled with the antivirals, including acyclovir, as well as the amino acid L‐lysine, both showing positive and similar results in reducing the number of annual manifestations and the healing time of the lesions. The aim of this study is to report a case of PR in a child, to review the literature on the etiopathogenesis of the disease and on the effects of L‐lysine as well as another amino acid in the treatment. An 11‐year‐old girl, phototype II, presented lesions diagnosed as PR. The cycle would be 6 to 8 weeks on average. A solution of L‐lysine was prescribed for 30 days, on an empty stomach. After the fourth day of therapy, the cycle of new eruptions was interrupted, initial lesions regressed, accelerating the repair of larger lesions resulting in an improvement of the clinical condition. We concluded that the administration of L‐lysine, in therapeutic doses, can be a safe alternative for the PR control.     

玫瑰糠疹的研究进展

一些病毒包括HHV-6、HHV-7、HHV-8、甲型H1N1流感病毒以及很多种药物与部分玫瑰糠疹发病有关,T淋巴细胞介导的细胞免疫在玫瑰糠疹的发生、发展中起重要的作用,HLA-DQB1*04可能参与玫瑰糠疹发病的遗传易感性.部分玫瑰糠疹临床表现不典型,皮疹形态、大小、分布、部位、数量及病程等与典型玫瑰糠疹不同.妊娠期的玫瑰糠疹患者早产、流产的发生率较高.药物诱导所致的玫瑰糠疹病情相对较重.目前尚无特异性疗法,阿昔洛韦、UVB、UVA1在部分玫瑰糠疹的治疗中显示较好的临床疗效.     

Vesicular pityriasis rosea: an atypical presentation

Pityriasis rosea (PR) is an acute, self-limited papulosquamous dermatosis localized on the trunk and extremities. PR is seen most frequently in adolescents and young adults. Many atypical forms of the disease have been reported in the literature. We report a rare atypical type of PR with vesicles on the erythematous macules and plaques.     

Localised pityriasis rosea‐like eruption during radiotherapy. Report of 2 cases

Pityriasis rosea is a common skin condition that presents acutely with asymptomatic, scaly and oval plaques, usually in a well‐recognised distribution over the trunk. Two men developed ovoid, scaly and annular lesions limited to the radiotherapy field during treatment for pelvic malignancies and without a preceding herald patch. Other causes of the eruption were excluded on clinical and pathological grounds and the histopathological features were consistent with a pityriasis rosea‐like eruption. In both cases the lesions resolved spontaneously by 8 weeks. These are the first reported cases of a localised pityriasis rosea‐like eruption arising during radiotherapy.