Ho Chi Minh City Ms. Hien, 33 years old, had a few red spots on her stomach, which then spread to form patches all over her body, causing flaking and roughness. The doctor diagnosed her with a rare disease called pityriasis rosea pilaris.
The red spots appeared most on the abdomen, chest, back, neck, and arms, making Ms. Hien worried and self-conscious, forcing her to wear long clothes to cover her body. She went to another hospital for examination and was diagnosed with pityriasis rosea. After several weeks of treatment without improvement, the rash became more and more dense, forming large scaly red patches, causing dry skin and severe itching.
On March 19, Dr. Nguyen Thi Kim Dung, a dermatologist and cosmetic dermatologist at Tam Anh General Hospital in Ho Chi Minh City, said that symptoms of red, scaly skin can easily be misdiagnosed as psoriasis. However, during clinical examination, the doctor noticed some special features such as red-orange lesions with thin scales; hyperkeratosis of hair follicles; between the lesions there are interspersed islands of healthy skin, distributed on the back, shoulders, abdomen, chest, arms, and scattered on the thighs; no psoriasis-like nail lesions were seen...
The patient was instructed to take tissue samples from the rash area for biopsy. The results showed that Ms. Hien had Pityriasis rubra pilaris (PRP), a rare disease. According to Dr. Dung, the incidence of this disease in the population has not been fully documented. A report from the British Dermatological Association showed that the incidence of the disease is about 1/400,000 people.
The doctor prescribed oral vitamin A derivatives (retinoids) that have anti-inflammatory effects, reduce follicular keratinization, apply body moisturizer, and change shower gel to a gentle one for Ms. Hien's skin. The medicine usually takes effect after 3-6 months. However, after two months of treatment, Ms. Hien's condition improved by about 95%, with only a few hyperpigmented patches remaining that will spontaneously return to normal color over time.
Ms. Hien's hand before and after treatment. Photo: Hoang Lien Son
Dr. Ly Thien Phuc, a specialist in Dermatology - Skin Aesthetics, said that pityriasis rosea pilaris can occur in both men and women of all ages, but mainly in the 5-10 age group or 51-60 age group. The mechanism of the disease is unclear, it can be genetic (if it is due to dominant genes, it will start in childhood) or acquired after infection, exposure to UV rays, use of drugs or after vaccination...
Acquired cases are common in adults, with a good prognosis when diagnosed and treated promptly. The disease can stabilize, gradually decrease, and resolve spontaneously after three years. If it is hereditary, treatment is more difficult, and the disease can last a lifetime.
The symptoms of pityriasis rosea pilaris are easily confused with common skin diseases such as psoriasis or pityriasis rosea Gibert. If misdiagnosed and treated incorrectly, the disease can progress to cause serious complications such as bacterial infection, fungal infection, erythema of the whole body, dehydration, heat shock, and metabolic disorders, according to Dr. Phuc.
Prolonged red, scaly skin also affects the patient's psychology, quality of life, aesthetics, and communication. Self-treatment with folk remedies such as applying leaves, bathing in lime water, or traditional medicine can make the disease worse, cause secondary infections, and increase treatment costs.
Dr. Dung said that the medicine to treat this disease is highly effective but also causes some side effects such as increased liver enzymes, blood fat, dry skin, dry mucous membranes, and should not be used for pregnant and lactating women... Patients need to have regular check-ups and blood tests to monitor, control side effects, and adjust the appropriate dosage of medicine.
Doctors recommend that when people have unusual symptoms on their skin, especially when the lesions spread over a large area such as scaly rash, severe itching, they should go to medical facilities with dermatology specialists for examination and appropriate treatment.
Anh Thu
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