Pityriasis Rotunda

Pityriasis Rotunda

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Pityriasis rotunda (PR) is an idiopathic, chronic dermatosis that features characteristic discrete, round, scaly, pigmented patches. [1, 2, 3, 4, 5, 6, 7, 8, 9, 10] Pityriasis rotunda may be associated with systemic diseases (eg, hepatocellular carcinoma) in certain racially predisposed groups.

The pathophysiology of pityriasis rotunda is unknown. It may be a variant of ichthyosis vulgaris.

United States

Pityriasis rotunda is very uncommon in America. A review of English-language literature revealed only 6 case reports from America, which described 7 patients. [1, 11, 12, 13, 14, 15]

International

Pityriasis rotunda is a well-known condition in South Africa, Japan, and Italy. Pityriasis rotunda was seen in 65 (1.01%) of 6388 South African medical inpatients. Japanese investigators reported 181 cases of pityriasis rotunda in 1960. Forty-two cases, all from the Italian island of Sardinia, were reviewed in 1997. [16] In 1989, one review of the English-language literature discussed 89 previously reported pityriasis rotunda patients. Cases of pityriasis rotunda have been reported in Israel, England, Egypt, Portugal, Tanzania, and India. [2, 17, 18, 19, 20, 21, 22]

Most cases of pityriasis rotunda from South Africa, and all 6 cases from America, have occurred in blacks.

In the 1960 review of 181 cases in the French-language literature (performed by Japanese investigators), 175 patients were from Japan, 4 were from Korea, and 2 were from Manchuria. [23]

Cases have been reported among West Indians living in England. [19]

Other than the cluster of 42 patients (some familial) reported from the Italian island of Sardinia, pityriasis rotunda appears to be very uncommon among whites. [16, 24]

No sex predilection has been demonstrated in several large series. One series had 77 males and 63 females; another had 73 males and 101 females. The report of Sardinian patients had 22 males and 20 females. [16]

Lesions are often first noted in adulthood, usually when aged 20-45 years, but a patient as old as 76 years has been reported. In the review of 42 cases from Sardinia, the average age of onset was estimated to be 3-7 years.

The prognosis for pityriasis rotunda is excellent. Pityriasis rotunda lesions sometimes resolve with treatment of the associated systemic disorder. Lesions of pityriasis rotunda are not associated with mortality, and most are asymptomatic. Pityriasis rotunda can occur with serious underlying systemic diseases, such as hepatocellular carcinoma. [25, 26]

Waisman M. Pityriasis rotunda. Cutis. 1986 Oct. 38(4):247-8. [Medline].

Pinto GM, Tapadinhas C, Moura C, Afonso A. Pityriasis rotunda. Cutis. 1996 Dec. 58(6):406-8. [Medline].

Grimalt R, Gelmetti C, Brusasco A, Tadini G, Caputo R. Pityriasis rotunda: report of a familial occurrence and review of the literature. J Am Acad Dermatol. 1994 Nov. 31(5 Pt 2):866-71. [Medline].

L’Henaff N, Combemale P. [Pityriasis rotunda. Review of the literature]. Ann Dermatol Venereol. 1993. 120(4):305-9. [Medline].

Mastura U. Uber kreisrunde pityriasis. Jpn Z Derm Urol. 1906. 6:3-4.

Pari T, Pulimood S, George S, Jacob M. Pityriasis rotunda. J Eur Acad Dermatol Venereol. 1998 Jul. 11(1):82-3. [Medline].

Toyama T. Uber eine bisher noch nicht beschriebene dermatose: “pityriasis circinata”. Arch Dermatol Syphiligr. 1913. 116:243-58.

Toyama T. Uber eine schuppende, pigmentierte: kreisrunde hautaffektion. Jpn Z Derm Urol. 1906. 6:2.

Weiss RM. Pityriasis rotunda. Arch Dermatol. 1989 Jul. 125(7):1002. [Medline].

Zina AM, Ubertalli S, Bundino S. Pityriasis rotunda. Int J Dermatol. 1986 Jan-Feb. 25(1):56-7. [Medline].

Finch JJ, Olson CL. Hyperpigmented patches on the trunk of a Nigerian woman. Pityriasis rotunda (PR). Arch Dermatol. 2008 Nov. 144(11):1509-14. [Medline].

Mafong EA. Pityriasis rotunda. Dermatol Online J. 2002 Oct. 8(2):15. [Medline].

Porges DY, Scott RA. Pityriasis rotunda with HTLV-1 associated tropical spastic paraparesis. NY. 1992. 184A.

Rubin MG, Mathes B. Pityriasis rotunda: two cases in black Americans. J Am Acad Dermatol. 1986 Jan. 14(1):74-8. [Medline].

Lefkowitz EG, Natow AJ. Pityriasis Rotunda: A Case Report of Familial Disease in an American-Born Black Patient. Case Rep Dermatol. 2016 Jan-Apr. 8 (1):71-4. [Medline].

Aste N, Pau M, Aste N, Biggio P. Pityriasis rotunda: a survey of 42 cases observed in Sardinia, Italy. Dermatology. 1997. 194(1):32-5. [Medline].

Gibbs S. Pityriasis rotunda in Tanzania. Br J Dermatol. 1996 Sep. 135(3):491-2. [Medline].

Gupta S. Pityriasis rotunda mimicking tinea cruris/corporis and erythrasma in an Indian patient. J Dermatol. 2001 Jan. 28(1):50-3. [Medline].

Sarkany I, Hare PJ. Pityriasis rotunda (pityriasis circinata). Br J Dermatol. 1964 May. 76:223-8. [Medline].

el-Hefnawi H, Rasheed A. Pityriasis rotunda. “Pseudo-ichtyose acquise en taches circulaires”: report and study of first case in UAR. Arch Dermatol. 1966 Jan. 93(1):84-6. [Medline].

Hasson I, Shah P. Pityriasis rotunda. Indian J Dermatol Venereol Leprol. 2003 Jan-Feb. 69(1):50-1. [Medline].

Segal R, Hodak E, Sandbank M. Pityriasis rotunda in a Caucasian woman from the Mediterranean area. Clin Exp Dermatol. 1989 Jul. 14(4):325-7. [Medline].

Ito M, Tanaka T. Pseudo-ichthyose acquise en taches circulaires. Ann Dermatol Syphiligr. 1960. 87:26-37.

Kahana M, Levy A, Ronnen M, Schewach-Millet M, Stempler D. Pityriasis rotunda in a white patient. Report of the second case and review of the literature. J Am Acad Dermatol. 1986 Aug. 15(2 Pt 2):362-5. [Medline].

Berkowitz I, Hodkinson HJ, Kew MC, DiBisceglie AM. Pityriasis rotunda as a cutaneous marker of hepatocellular carcinoma: a comparison with its prevalence in other diseases. Br J Dermatol. 1989 Apr. 120(4):545-9. [Medline].

DiBisceglie AM, Hodkinson HJ, Berkowitz I, Kew MC. Pityriasis rotunda. A cutaneous marker of hepatocellular carcinoma in South African blacks. Arch Dermatol. 1986 Jul. 122(7):802-4. [Medline].

Ena P, Cerimele D. Pityriasis rotunda in childhood. Pediatr Dermatol. 2002 May-Jun. 19(3):200-3. [Medline].

Combemale P, L’Henaff N, Guennoc B. [Pityriasis rotunda]. Ann Dermatol Venereol. 1993. 120(4):287-8. [Medline].

Swift PJ, Saxe N. Pityriasis rotunda in South Africa–a skin disease caused by undernutrition. Clin Exp Dermatol. 1985 Sep. 10(5):407-12. [Medline].

Lodi A, Betti R, Chiarelli G, Carducci M, Crosti C. Familial pityriasis rotunda. Int J Dermatol. 1990 Sep. 29(7):483-5. [Medline].

Friedmann AC, Ameen M, Swale VJ. Familial pityriasis rotunda in black-skinned patients; a first report. Br J Dermatol. 2007 Jun. 156(6):1365-7. [Medline].

Guberman D, Lichtenstein DA, Gilead L, Vardy DA, Klaus SN. Familial pityriasis rotunda. Acta Derm Venereol. 1997 Mar. 77(2):162. [Medline].

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Ramos-E-Silva M, Carvalho JC, Carneiro SC. Cutaneous paraneoplasia. Clin Dermatol. 2011 Sep-Oct. 29(5):541-7. [Medline].

Abreu Velez AM, Howard MS. Diagnosis and treatment of cutaneous paraneoplastic disorders. Dermatol Ther. 2010 Nov-Dec. 23(6):662-75. [Medline].

Weiss RM. Pigmented lesions in a patient with pulmonary tuberculosis. Pityriasis rotunda. Arch Dermatol. 1991 Aug. 127(8):1221, 1224. [Medline].

Leibowitz MR, Weiss R, Smith EH. Pityriasis rotunda. A cutaneous sign of malignant disease in two patients. Arch Dermatol. 1983 Jul. 119(7):607-9. [Medline].

Etoh T, Nakagawa H, Ishibashi Y. Pityriasis rotunda associated with multiple myeloma. J Am Acad Dermatol. 1991 Feb. 24(2 Pt 1):303-4. [Medline].

Piga S, Cottoni F, Meloni GF. Pityriasis rotunda and G6PD deficiency. Int J Dermatol. 1992 Oct. 31(10):745. [Medline].

Jaggi Rao, MD, FRCPC Clinical Professor of Medicine, Division of Dermatology and Cutaneous Sciences, Director of Dermatology Residency Program, University of Alberta Faculty of Medicine and Dentistry

Jaggi Rao, MD, FRCPC is a member of the following medical societies: American Academy of Dermatology, American Society for Dermatologic Surgery, American Society for Laser Medicine and Surgery, Canadian Medical Association, Pacific Dermatologic Association, Royal College of Physicians and Surgeons of Canada, Canadian Medical Protective Association, Canadian Dermatology Association

Disclosure: Nothing to disclose.

Andrei I Metelitsa, MD, FRCPC Assistant Clinical Professor, Section of Dermatology, University of Calgary Faculty of Medicine, Canada

Andrei I Metelitsa, MD, FRCPC is a member of the following medical societies: American Academy of Dermatology, American Society for Dermatologic Surgery, American Society for Laser Medicine and Surgery, Canadian Medical Protective Association, Canadian Dermatology Association

Disclosure: Nothing to disclose.

Andrew Lin, MD, FRCPC † Associate Professor, Department of Internal Medicine, Division of Dermatology, University of Alberta

Andrew Lin, MD, FRCPC is a member of the following medical societies: American Academy of Dermatology, Royal College of Physicians and Surgeons of Canada

Disclosure: Nothing to disclose.

Richard P Vinson, MD Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Texas Medical Association, Association of Military Dermatologists, Texas Dermatological Society

Disclosure: Nothing to disclose.

Jeffrey Meffert, MD † Former Associate Clinical Professor of Dermatology, University of Texas School of Medicine at San Antonio

Jeffrey Meffert, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, Association of Military Dermatologists, Texas Dermatological Society

Disclosure: Nothing to disclose.

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

James W Patterson, MD Professor of Pathology and Dermatology, Director of Dermatopathology, University of Virginia Medical Center

James W Patterson, MD is a member of the following medical societies: American Academy of Dermatology, American College of Physicians, American Society of Dermatopathology, Royal Society of Medicine, Society for Investigative Dermatology, United States and Canadian Academy of Pathology

Disclosure: Nothing to disclose.

Pityriasis Rotunda

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