Gibert’s pityriasis rosea: What it Is and How to Treat It

“Gibert’s pityriasis rosea, initially called annular roseola,” explains Dr. Guanziroli, “is a benign skin condition characterized by patches that are:

• Oval-shaped,
• Salmon-pink in color (in people with darker skin, the color may tend toward gray or brown),
• Finely scaly at the edges,
• Well-defined, with a central area resembling ‘cigarette paper’—dry and wrinkled.”

The disease is named after the French dermatologist Camille Melchior Gibert, who first described it in 1860.

This benign skin disease can affect both genders and all age groups but is most common among:

• Children and adults aged 10 to 35
• Pregnant women, likely due to immune response changes

Pityriasis rosea typically begins with a single, isolated lesion (herald patch), usually 1–3 cm in diameter but sometimes up to 10 cm, appearing on the trunk, neck, or the root of the limbs.

After a few days or weeks, a rash develops with smaller, symmetrical spots (secondary patches) about 0.5–1.5 cm in size, appearing on the:

• Chest
• Abdomen
• Back
• Neck
• Limbs

The face is usually unaffected, and scalp involvement is rare. The patch is typically the only symptom of the disease, although in rare cases, it may cause mild to intense itching.

Sometimes, a few weeks before the rash appears, flu-like symptoms may occur, including:

• Headache
• Fatigue
• Fever
• Joint pain

Symptoms of Atypical Forms

In about 20% of cases, pityriasis rosea presents with atypical manifestations, such as:

• Red, swollen welts
• Vesicles
• Crusty lesions
• Absence of the herald patch
• Large patches primarily affecting the scalp, genital area, and oral mucosa (with erosions and bleeding)
• Intense and persistent itching lasting for months

The exact cause of pityriasis rosea remains unknown. However, a viral infection involving certain herpes viruses—specifically human herpesvirus 6 and 7—may be responsible.

The disease usually lasts 1–2 months but can persist for up to 3 months. In rare cases, mild recurrences may occur even years later.

Pityriasis rosea is not contagious. Household transmission is extremely rare, so affected individuals can continue their daily activities without the need for isolation.

However, special precautions should be taken for newborns and pregnant women to avoid potential transmission via respiratory droplets.

Diagnosis is primarily clinical, based on observing the herald patch and the appearance and distribution of secondary patches.

In some cases, differential diagnosis is necessary to rule out other conditions with similar presentations, such as:

• Ringworm (Tinea corporis): A contagious fungal infection
• Psoriasis: A chronic inflammatory skin disease with thicker plaques and scales, sometimes itchy
• Nummular eczema: A type of dermatitis with circular lesions, often more itchy
• Secondary syphilis: A sexually transmitted disease that can sometimes involve the palms and soles

In uncertain cases, a microscopic examination, biopsy, or serological tests may help confirm the diagnosis.

“Pityriasis rosea is considered a ‘self-limiting’ disease, meaning it resolves on its own without leaving scars or requiring medical treatment,” explains Dr. Guanziroli.

However, if itching occurs, the following treatments may help:

• Moisturizing creams
• Antihistamines
• Corticosteroids (if itching is severe or lesions are inflamed)

In certain cases, such as during the first 15 weeks of pregnancy, pityriasis rosea may lead to complications and increase the risk of miscarriage.

Therefore, if there is any diagnostic uncertainty, or to differentiate it from other conditions with similar symptoms, it is always advisable to consult a doctor.