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Enanthemas commonly observed in non-classic pityriasis rosea

Enanthemas were commonly reported among patients with non-classic forms of pityriasis rosea, including persistent and pediatric forms of the disease.

The retrospective study included an analysis of the oropharyngeal mucosa of 527 patients with pityriasis rosea accrued at a single center in Italy between 2003 and 2016. Associations have been reported between pityriasis rosea and endogenous reactivation of both human herpesvirus-6 and human herpesvirus-7, according to the investigators. They added that despite evidence of a possible association between oropharyngeal lesions and exanthema, many dermatologists may be unaware of this incidence. The aim of the current study was to classify and establish the prevalence of oropharyngeal lesions and describe how they may be linked to pityriasis rosea.

Results indicated painless oropharyngeal lesions in 28% of the cohort. These lesions were categorized as erythematomacular, macular and papular, erythematovesicular, and petechial, according to the findings.

Overall, the most commonly reported patterns were petechial and macular and papular. Levels of the two herpesvirus strains were not statistically significantly different in patients with enanthema and patients without enanthema.

In addition to the classic form, the classifications of pityriasis rosea included pediatric, relapsing, persistent, those associated with pregnancy, and pityriasis rosea-like eruptions.

Oropharyngeal petechia were found in 75% of 24 patients with persistent disease and 59% of those in the pediatric group. Macular papules were common across types, but were found most commonly, at 62%, in relapsing pityriasis rosea. Erythematous vesicles occurred in 22% of pregnant women, while erythematous macules occurred in 41% of patients with classic disease.

The most common symptom reported in patients with enanthema was sore throat, which occurred in approximately 90 of 101 patients. Fatigue and headache occurred in the enanthema group and the non-enanthema group, along with fever, insomnia, anorexia, pruritus, nausea and irritability, according to the results.

Also in the enanthema group, systemic symptoms were more likely to occur in patients with persistent, relapsing, pediatric and pregnancy-associated disease than in the classic form (chi-square value, 31.1; P < .00001) – by Rob Volansky

Disclosure: The researchers report no relevant financial disclosures.