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Your QuestionAre there any other treatments for pityriasis lichenoides besides ultraviolet (UV) light treatment and topical cream?
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Pityriasis lichenoides is a skin disorder of unknown cause. There are two types of pityriasis lichenoides; a more severe form with a sudden onset that tends to be short-lived (acute) which is usually found in children, known as pityriasis lichenoides et varioliformis acuta and a more mild but long-lasting (chronic) form known as pityriasis lichenoides chronica. Pityriasis lichenoides chronica may clear up in a few weeks or persist for years.
Last updated: 9/20/2011
PLEVA is a skin disorder that is a more severe form of pityriasis lichenoides. The first symptom of the disease is usually red patches that quickly evolve into papules. The papules erupt into lesions that are filled with puss and blood, which often heals with scarring and changes in skin coloring (pigmentation), either becoming darker or lighter. The skin eruption may cause burning or itching and can look like chicken pox. The face is rarely affected, but the spots are usually scattered on the trunk and limbs. Those with PLEVA may also experience a low-grade fever, headache, malaise (a vague feeling of bodily discomfort), and severe joint pain; these symptoms may occasionally precede or accompany the skin findings.
Last updated: 1/3/2012
PLC is the milder form of pityriasis lichenoides, and the lesions associated with this form consist of small, firm, red-brown spots. Unlike PLEVA, the lesions are not irritating and have mica-like adherent scale, which can be scraped off to reveal a shiny brown surface. The spot flattens out over several weeks to leave a brown mark which fades over several months. PLC can look like psoriasis, lichen planus, or insect bites.
Last updated: 7/19/2013
The different forms of treatment for pityriasis lichenoides that have been used range from natural sunlight exposure to chemotherapeutic agents. Treatment may not be necessary if the rash is not causing symptoms. When itching is severe, topical corticosteroids, tar preparations, and antihistamines may provide relief without changing the course of the disease. In adult patients, administration of methotrexate and oral tetracycline has led to good results; however, these medications are inappropriate for first-line treatment in young children. In addition to tetracycline, erythromycin is another antibiotic that is commonly used to treat pityriasis lichenoides. Sunlight is helpful, and excellent therapeutic responses to UVB phototherapy are documented. UVB therapy is more difficult in young children, and there is little data regarding the long-term risks of phototherapy in the pediatric population. It is difficult to interpret the results of formal therapy evaluations because of the frequency of spontaneous remissions.
Last updated: 7/19/2013
- Pityriasis lichenoides. British Association of Dermatologists Web site. August 2004; http://www.bad.org.uk/site/855/default.aspx. Accessed 4/29/2010.
- Ersoy-Evans S, Fernanda Greco M, Mancini AJ, Subasi N, Paller AS. Pityriasis lichenoides in childhood: A retrospective review of 124 patients. J Am Acad Dermatol. Feb 2007; 56(2): 205-210. http://www.ncbi.nlm.nih.gov/pubmed/17097385.
- Bowers S, Warshaw EM. Pityriasis lichenoides and its subtypes. J Am Acad Dermatol. Oct 2006; 55(4): 557-572. http://www.ncbi.nlm.nih.gov/pubmed/17010734.
- Pityriasis lichenoides. New Zealand Dermatological Society Web site. 2011; http://dermnetnz.org/scaly/pityriasis-lichenoides.html. Accessed 1/3/2012.