Pityriasis lichenoides

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD's weight loss doctor NYC
Philadelphia GLP-1 weight loss and GLP-1 clinic NYC

Pityriasis lichenoides
Pityriasis lichenoides
Synonyms
Pronounce
Specialty	Dermatology
Symptoms	Rash, papules, scales
Complications
Onset
Duration
Types	Pityriasis lichenoides et varioliformis acuta, Pityriasis lichenoides chronica
Causes	Unknown
Risks
Diagnosis	Clinical diagnosis, skin biopsy
Differential diagnosis	Psoriasis, lichen planus, secondary syphilis
Prevention
Treatment	Topical corticosteroids, phototherapy, antibiotics
Medication
Prognosis
Frequency	Rare
Deaths	N/A

Definition

Pityriasis lichenoides (PL) is a skin condition characterized by small, raised pink spots that tend to come together in groups.

Cause

• The exact cause of pityriasis lichenoides (PL) remains unknown.
• Theories on the cause have included the possibility of a low-grade or self-limited lymphoproliferative disorder; a hypersensitive reaction to a bacterial or viral infection; and an inappropriate, inflammatory immune response to an unknown foreign agent.
• The most commonly reported associated infections in people with PL are Epstein-Barr virus (EBV), Toxoplasma gondii, and human immunodeficiency virus (HIV).
• Other infections that have been associated with PL include cytomegalovirus, parvovirus (fifth disease), Staphylococcus aureus, and group A beta-haemolytic streptococci.
• Several therapies, such as chemotherapeutic agents, estrogen-progesterone therapy, the antihistamine astemizole, certain herbs (e.g. kampo), and the measles vaccine have also been linked to the onset of PL.
• However, no cause-effect relationship between PL and any of these infections or therapies has been proven.
• PL is not contagious.

Types

• There are two main types of PL: an acute form called pityriasis lichenoides et varioliformis acuta (PLEVA), and a milder, longer-lasting form called pityriasis lichenoides chronica (PLC).
• There is also a rare, severe variant of PLEVA called febrile ulceronecrotic PLEVA, associated with high fever and complications that may affect other body systems.

Signs and symptoms

• In both types of PL, spots usually occur on the trunk, buttox, arms and legs.
• PLEVA begins abruptly and may cause itching or burning.
• PLC may develop over days, is less irritating, and lasts longer than PLEVA.
• Spots associated with PLC typically fade within 3 to 4 weeks, but new spots may then appear.
• There is no clear consensus regarding how long either form of PL lasts, but most cases resolve on their own within one to several months.
• Some cases may wax and wane, or relapse over a period of years.

Diagnosis

• This condition is diagonised based on clinical history and appearance, and the diagnosis is confirmed by skin biopsy.
• The pathology of PLEVA and PLC are distinct.

Treatment

• Most cases of pityriasis lichenoides (PL) tend to resolve on their own over time.
• However, treatment may be used to decrease the duration of the condition, especially if the rash is a nuisance.
• Initial treatment for PL usually consists of topical or systemic corticosteroids, or oral antibiotics.
• However, these treatments may cause multiple side effects and are not always effective.
• Natural sunlight and/or phototherapy treatment may be helpful.
• A combination of tablets known as Psoralens with UVA (PUVA treatment) may also be helpful, but carries a higher risk of side effects.
• Severe forms of the disease may be managed by medications that suppress the immune response (immunosuppressants).

DermNet scaly/pityriasis-lichenoides

NIH genetic and rare disease info

• NIH info on Pityriasis lichenoides

Pityriasis lichenoides is a rare disease.