The return of round, scaly patches

Question:

I am 22 years old and developed a round, scaly patch on the left side of my stomach that was scaly around the edge and like normal skin in the middle. It was about the size of a silver dollar and did not itch. I looked on the internet, and my spot looked like ring worm. I tried over-the-counter clotrimazole twice a day. After two weeks, not only did it not go away, but I began to get a lot more spots, many on my trunk. I feel fine, but look bizarre; and my boyfriend said I need to go see the dermatologist. Do I really need to go spend the money if I feel fine?

Answer:

To be on the safe side, you should see the dermatologist. However, your rash may be pityriasis rosea, sometimes just called “PR” by medical personnel. It is a common, harmless skin disorder. The cause is unknown, and the rash is not contagious.

There is no evidence to suggest pityriasis rosea is caused by foods, medications or nerves. It usually begins with a single, scaly, round to oval spot called the “mother spot” or “herald patch.” It appears in as little as 2-3 days up to 2-3 weeks before the more generalized rash. The rash covers mainly the trunk, but may spread to the arms, legs, and neck. Pityriasis rosea usually avoids the face, palms, and soles. Untreated, the rash generally lasts 4-12 weeks. Should the rash persist greater than 12 weeks, consultation with a dermatologist is recommended. Resolution of the rash leaves the skin in its normal state with no scarring.

As a general rule, nature will cure pityriasis rosea, however, sometimes very slowly. The rash may itch, can be irritated by certain soaps, and certainly does not look good if the areas involved are exposed. Treatment should include mild soaps and over-the-counter hydrocortisone cream 1% applied twice daily to eliminate the itching and speed the recovery of the rash. Ultraviolet light from the sun or artificial tanning beds generally shortens the duration of the rash. If conservative measures fail to improve the symptoms, there are prescription medications available that are very effective.

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