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Atypical pityriasis rosea in a young Colombian woman. Case report
Pitiriasis rosada atípica en una joven colombiana. Reporte de caso
DOI:
https://doi.org/10.15446/cr.v7n2.88809Palabras clave:
Pityriasis Rosea, Exanthema, Herpesviridae (en)Seleccionado:Pitiriasis, Exantema, Herpesviridae (es)
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Introduction: Pityriasis rosea is an acute and self-limited exanthem
first described by Gilbert in 1860. Its treatment is symptomatic, and although there is no conclusive evidence, it has been associated with the reactivation of the human herpesviruses 6 and 7 (HHV-6 and HHV-7).
Case presentation: A 28-year-old woman, from Bogotá, Colombia, a
health worker, attended the emergency room due to the onset of
symptoms that began 20 days earlier with the appearance of punctiform
lesions in the left arm that later spread to the thorax, abdomen, opposite arm, and thighs. The patient reported a history of bipolar II disorder and retinal detachment. After ruling out several infectious diseases, and due to the evolution of the symptoms, pityriasis rosea was suspected. Therefore, treatment was started with deflazacort 30mg for 21 days, obtaining a favorable outcome and improvement of symptoms after 2 months. At the time of writing this case report, the patient had not consulted for recurrence.
Conclusion: Primary care physicians should have sufficient training in
dermatology to recognize and treat dermatological diseases since many
of them are diagnosed based on clinical findings. This is an atypical
case, in which the patient did not present with some of the pathognomonic signs associated with pityriasis rosea.
Introducción. La pitiriasis rosada es un exantema agudo y autolimitado
que fue descrito formalmente por Gilbert en 1860. Su tratamiento es sintomático y, aunque faltan pruebas concluyentes, su aparición se ha
asociado a la reactivación de los herpevirus humanos 7 y 6 (HHV6 y
HHV7).
Presentación del caso. Mujer de 28 años procedente de Bogotá,
Colombia, quien se desempeñaba como trabajadora de la salud y
consultó al servicio de urgencias por un cuadro clínico de 20 días de
evolución que inició con la aparición de lesiones punteadas en el brazo
izquierdo que se expandieron posteriormente a tórax, abdomen, brazo contralateral y muslos. La paciente informó antecedente de trastorno bipolar tipo II y desprendimiento de retina. Después de descartar varias enfermedades infecciosas, y debido a la evolución del cuadro clínico, se sospechó pitiriasis rosada, por lo que se instauró tratamiento con 30mg de deflazacort por 21 días, con el cual se logró una evolución favorable y la mejoría total de los síntomas a los 2 meses. Hasta el momento de la elaboración del presente reporte de caso la joven no había consultado por recurrencia.
Conclusión. Es indispensable que los médicos de atención primeria
tengan una educación adecuada en dermatología para poder reconocer y
tratar la pitiriasis rosada, pues su diagnóstico es eminentemente clínico
y puede tener múltiples presentaciones atípicas, como en el caso aquí reportado donde la paciente no tuvo algunos de los signos patognomónicos característicos.
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