‘Widespread Ringworm’ On Black Skin: Pityriasis Rosea

‘Widespread Ringworm’ On Black Skin: Pityriasis Rosea

This blog post is to educate and reassure patients and their relatives who have been diagnosed with the condition by their physician.

Pityriasis Rosea (PR) is a fairly common skin condition that presents like widespread ringworm on black skin. About 80% of the time it presents with what is called the ‘Herald Patch’, which is the first ringworm-like lesion that is usually large and circular. The herald patch is usually located on the trunk but occasionally occurs on the upper arms.

Ringworm-like: Circular lesions with a scaly central portion with slightly raised edges (annular papalosquamous rashes)

What Causes It?

At the moment, the aetiology of PR is not fully understood. Some scientists have attributed it to viral illnesses and that it tends to occur towards the beginning and the end of the rainy season in our tropical climate.

How Is It Diagnosed?

It is diagnosed clinically, by taking a history and doing a clinical examination that reveals the characteristic multiple ringworm-like lesions and a probably healing herald patch. Some cases may have the rashes distributed on the back in a christmas tree pattern.

How Is It Treated?

There is no treatment for the condition as it is a self-limiting illness- The disease resolves spontaneously after a while- usually between four to twelve weeks.

Serious Concern

The most serious concern of the condition apart from the occasional itchiness, is how ugly the rashes look and its effect on the self-esteem of those affected.

Thankfully, it spares the face most of the time so long sleeve clothing and trousers can effectively conceal most of the lesions. You have done absolutely nothing wrong to have come down with the condition and it is only a matter of time, as the rashes eventually disappear completely with no trace in most people affected.

Supportive Care

If there is itching the doctor would prescribe anti-histamines or mild topical steroids.

Moisturising baths with anti-inflammatory shampoos (e.g SelSun Shampoo) help to keep the inflammation down and the skin moisturised for the skin to have a faster recovery.

Emollients like moisturising creams also play a good role in keeping the skin in good condition for healing to occur.

Finally

  • The cause of Pityriasis Rosea is largely unknown.
  • It is NOT from poor hygiene.
  • It looks like widespread ringworm and is usually very unsightly.
  • There is no cure and the condition is self-limiting as it resolves spontaneously within 6 weeks in most of the cases.
  • Wear covering clothing for aesthetics, bath with a moisturising shampoo and take anti-histamines prescribed by your doctor, if any.

Images

Left Upper Arm

Image taken with consent from the patient and a verbal permission to use for educational purposes

Back

Image taken with consent from the patient and a verbal permission to use for educational purposes

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