J Korean Med Sci.  2022 Jun;37(24):e190. 10.3346/jkms.2022.37.e190.

Impact of COVID-19 on Clinicopathological Spectrum of Pityriasis Rosea in Korea

• Kim DH
• Cho JH
• Park SJ
• Seo SH
• Ahn HH

• KMID: 2530503
• DOI: http://doi.org/10.3346/jkms.2022.37.e190

Abstract

Background
Pityriasis rosea (PR) is a papulosquamous eruption with generally unknown origin but suspected to be related to viral etiologies. The clinicopathological spectrum of several disorders with viral etiologies has been altered after the coronavirus disease 2019 (COVID-19) pandemic. The author group could experience coherent histological alterations in PR after the COVID-19 pandemic. This study aimed to investigate how the clinicopathological findings of PR were changed after the COVID-19 pandemic.
Methods
Patients (n = 11) diagnosed with PR based on the clinical manifestations and skin biopsies between February 2018 and October 2019 and 11 patients in February 2020 and October 2021 were retrospectively analyzed by investigating the medical records.
Results
The patients with PR during the COVID-19 pandemic demonstrated statistically significant histopathological alterations from classic brisk and dense infiltration pattern to dormant and sparse infiltration and psoriasiform-dominant patterns (P = 0.019). PR was associated with more frequent pruritus during the pandemic period (P = 0.027).
Conclusion
In conclusion, PR demonstrated a significant histopathological alteration with more frequent pruritus during the COVID-19 pandemic. The comparative results about clinicopathological findings of PR will provide a useful reference for dermatologists in the diagnostic process of PR in the COVID-19 pandemic.

Keyword

Pityriasis Rosea; Clinicopathological Spectrum; COVID-19; Histopathological Alteration; Pruritus

Figure

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  Fig. 1 The morphological or regional patterns of secondary eruption observed in (A, B) typical and (C-G) atypical PR. (A) Macular and (B) papular types are commonly observed in the truncal region of patients with typical PR. The secondary lesions can also be atypically presented morphologically as (C) erythema multiforme-like eruption and (D) PR gigantea of Darier. The atypical distribution of secondary eruptions includes the (E) inframammary, (F) inguinal, and (G) axillary regions.PR = pityriasis rosea.

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  Fig. 2 Histopathologic classification of patients with pityriasis rosea. (A) brisk and dense infiltration, (B) dormant and sparse infiltration, and (C) psoriasiform pattern (hematoxylin and eosin, ×100, scale bar, 200 µm).

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