Papular pityriasis rosea with palmar involvement an atypical presentation

Abstract : Pityriasis rosea is a self limiting exanthem of possible viral origin, usually lasting for 4 to 7 weeks. Many atypical forms of pityriasis rosea have been described in literature. We describe a papular variant of pityriasis rosea with palmar involvement. A twenty eight year old male presented with complaints of generalized itchy skin lesions for 4 days and history of exposure to white cement 7 days back. It was initially thought as an allergic contact dermatitis to cement. On dermatological examination there were multiple erythematous papules over chest, back and proximal portions of both upper limbs and multiple erythematous scaly patches over both lower limbs and a few of them showed peripheral collarette of scales. Scaly eruptions were also observed over the palms. Skin biopsy was done and the patient was treated with emollients. On follow up after 3 weeks the lesions got resolved spontaneously and histological examination was suggestive of pityriasis rosea. Keyword :pityriasis rosea, papular pityriasis rosea, herald patch