Pityriasis Rotunda 

  • Author: Jaggi Rao, MD, FRCPC; Chief Editor: Dirk M Elston, MD   more...
 
Updated: Jan 24, 2012
 

Background

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.

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Pathophysiology

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

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Epidemiology

Frequency

United States

Pityriasis rotunda is very uncommon in America. A review of English-language literature revealed only 5 case reports from America, which described 6 patients.[1, 11, 12, 13, 14]

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.[15] 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, 16, 17, 18, 19, 20, 21]

Mortality/Morbidity

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.[22, 23]

Race

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.[24]

Cases have been reported among West Indians living in England.[18]

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.[15, 25]

Sex

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.[15]

Age

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.

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Contributor Information and Disclosures
Author

Jaggi Rao, MD, FRCPC  Associate Clinical Professor of Medicine, Division of Dermatology and Cutaneous Sciences, Director of Dermatology Residency Program, University of Alberta Faculty of Medicine and Dentistry; Founder and Director, Acne Clinics of Canada, Inc; Teledermatologist, Telederm Canada, Inc

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 Dermatology Association, Canadian Medical Association, Canadian Medical Protective Association, Pacific Dermatologic Association, and Royal College of Physicians and Surgeons of Canada

Disclosure: Nothing to disclose.

Coauthor(s)

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 Dermatology Association, and Canadian Medical Protective 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 and Royal College of Physicians and Surgeons of Canada

Disclosure: Nothing to disclose.

Specialty Editor Board

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, and United States and Canadian Academy of Pathology

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, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association

Disclosure: Nothing to disclose.

Jeffrey Meffert, MD  Assistant 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, and Texas Dermatological Society

Disclosure: Nothing to disclose.

Joel M Gelfand, MD, MSCE  Medical Director, Clinical Studies Unit, Assistant Professor, Department of Dermatology, Associate Scholar, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania

Joel M Gelfand, MD, MSCE is a member of the following medical societies: Society for Investigative Dermatology

Disclosure: AMGEN Consulting fee Consulting; AMGEN Grant/research funds Investigator; Genentech Grant/research funds investigator; Centocor Consulting fee Consulting; Abbott Grant/research funds investigator; Abbott Consulting fee Consulting; Novartis investigator; Pfizer Grant/research funds investigator; Celgene Consulting fee DMC Chair; NIAMS and NHLBI Grant/research funds investigator

Chief Editor

Dirk M Elston, MD  Director, Ackerman Academy of Dermatopathology, New York

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

Disclosure: Nothing to disclose.

References

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Nearly perfectly round, slightly hyperkeratotic, hyperpigmented, asymptomatic plaque on the trunk.
Classic histology for pityriasis rotunda demonstrating mild hyperkeratosis and a reduced granular layer in the epidermis.
 
 
 
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