Pityriasis Rosea- Causes, Symptoms, And Ayurvedic Treatment

ABSTRACT

Pityriasis Rosea is a common skin condition which causes raised red color scaly patches on the body. Skin diseases affect the various parts of the skin which causes rashes, inflammation and changes in skin colour. Skin diseases can be genetic or may be due to various lifestyle factors. Skin is the largest organ which protects the whole body. It is usually soft, flexible tissue which performs 3 functions Protection, Regulation and sensation. Mammalian skin is composed of 2 primary layers Epidermis and Dermis. Epidermis is the outermost layer of the skin which forms the protective barrier which prevents the entry of pathogens from entering. Dermis is the layer of skin which lies beneath the epidermis and provides tensile strength and elasticity to the skin. The skin has seven layers of ectodermal tissue which guards various tissues, bones, ligaments and various internal organs. In this article, we are going to discuss the causes, symptoms and ayurvedic aspects in detail further the topic.

INTRODUCTION

Pityriasis Rosea is a rash which begins as an oval spot on the face, chest and abdomen region. It is caused by a virus which begins with a single red and slightly scaly area known as Herald Patch. It is a self-limiting rash which resolves in about 6-10 weeks and further develops smaller scaly oval-shaped patches which resemble a Christmas tree. Commonly known as Pityriasis Circinata, Roseola Annulata and Herpes Tonsurans. Christmas Tree patterns appear mainly on the Trunk and Proximal Extremities. These rashes are itchy in nature and can happen in any age group which is between 10-35 years of age. Sometimes Malaise and fever occur before the start of the rashes and itchiness and sometimes can be due to Human Herpes 6 or Human Herpes 7.

PATHOPHYSIOLOGY

• It is due to Natural Killer Cell and B cell activity in Pityriasis rosea which suggests T Cell-mediated immunity.
• There is an increased amount of CD4 T-Cell and the Langerhans cells which are present in the dermis.
• Anti-immunoglobulin M Keratinocytes is found in Pityriasis Rosea.

HISTORY AND PHYSICAL

• Pityriasis rosea is oval scaly plaques which are seen on the trunk and proximal extremities with a Christmas tree appearance.
• Collarette Scaling is common with the prodrome of sore throat and gastrointestinal disturbance and arthralgia.
• The distribution of the lesions is bilateral and diffuse which runs parallel to the skin tensions.

The various Atypical Morphologies include

• Vesicular Pityriasis Rosea- It is an eruption of 2mm to 6 mm vesicles over the hand, palms and sole region. Commonly seen in children.
• Urticarial Pityriasis Rosea
• Purpuric Pityriasis Rosea which is present as macular purpura.
• Giant Pityriasis Rosea consists of a plaque on the palm of the patient.
• Pityriasis Rosea as exfoliative dermatitis.
• Pityriasis Rosea with Herald Patch is absent in 20% of patients present at an unusual site such as the Face, scalp and Genitalia.

WHO GETS PITYRIASIS ROSEA?

• It is most common in Teenagers and in young adults.
• More seen in women
• The incidence is 0.5-2 %
• Most cases occur in the winter season.

CAUSES

This can be due to Immunologic reactions such as viral infection, and bacterial infections.

• Viral infections- Herpes Virus 6 and 7 which is a strong association
• Influenza A such as H1N1 and Covid.

Drug-Induced reactions

It is strongly associated with Angiotensin-converting enzyme inhibitors and NSAIDs (Non-steroidal anti-inflammatory drugs).

Vaccines

It can be triggered by BCG (Bacillus Calmette Guerin), Diphtheria and Covid-19 vaccines.

CLINICAL FEATURES OF PITYRIASIS ROSEA?

1. Systemic Symptoms

It is typically present as a rash phase and has 69% symptoms of Flu-like symptoms such as Cough and Sore throat.

2. Herald Patch

It is a single patch which is slightly oval, a salmon pink plaque with a peripheral scale inside the edge of the lesion like a collaret.

3. Secondary Rash

It is a scaly plaque which appears on the back and chest and is a smaller lesion than a herald Patch which may be annular. It is due to Relaxed tension on skin lines and cleavage lines on the upper trunks.

ATYPICAL PITYRIASIS ROSEA

Pityriasis Rosea is atypical when it is not diagnosed, and shows features such as

• Large size plaques
• Mucosal sites involved such as lacerations in the mouth
• Multiple herald patches
• Absence of herald patches
• Severe itching
• Recurrence of the disease

DIFFERENTIAL DIAGNOSIS

• Lichen Planus
• Guttate Psoriasis
• Tinea Corporis
• Seborrheic Dermatitis
• Psoriasis

DIAGNOSIS

• Skin Biopsy
• Blood tests (IgG or PCR)

TREATMENT

1. General Measures

If it is self-limiting then the most important goal is to control the Pruritus.

• Apply moisturizing cream
• Apply aqueous cream and shower with plain water
• Exposing to the sun without burning

2. Specific Measures

There are other therapies such as

• Topical Steroid creams and various antihistamines reduce rashes and itching. Such as Calamine lotion.
• Light Therapy which is helpful in post-inflammatory hyperpigmentation
• Emollients- Moisturize skin which soothes the skin surface.
• Lukewarm water shower in oatmeal.

AYURVEDIC ASPECT

Skin is one of the most important organs of the body which is one of the Gyanendriya which performs the function of sensation and prevents the body from external shock. In ayurveda, Skin diseases come under Kushtha Rogas which are of two types- Mahakushta (7 types) and Kshudrakushta (11 types). Pityriasis Rosea comes under Mandala Kushta which is one of the Mahakushta. This disease involves the vitiation of Kapha doshas with dushya Rakta and Mamsa which affects the skin texture and causes physical and psychological disturbances. To analyse skin disease one must diagnose food habits, lifestyle and general health. An unhealthy diet leads to the formation of the Ama doshas which harm the skin and weakens the digestive fire.

PATHOGENESIS (SAMPRAPTI)

The vitiated doshas (Vata, Pitta and Kapha doshas) get vitiated into the Tvak (rasa dhatu), Blood (Rakta), Mamsa (Muscle tissue) and Ambu (lymph) are together known as Kushta dravya.

• Vata doshas lead to dryness in the skin with a much rough appearance having cracks and fissures.
• Pitta doshas lead to redness and burning pain with the formation of pus along with ulceration.
• Kapha doshas lead to white discoloration, itching and retention of fluids.

SAMPRAPTI GHATAKA

• Doshas-Tridoshas mainly Kapha doshas.
• Dushya- Rasa and Rakta
• Adhishtana- Twaka

CHIKITSA

Panchkarma is one of the best ayurvedic procedures which is helpful in restoring the doshic balance and promotes the health of the skin by removing the accumulated doshas in the body.

1. SHODHANA CHIKITSA

Panchkarma procedures such as Vamana and Raktamokshana which is helpful in removing the accumulated toxins and boosts the circulatory process which maintains calmness and physical and mental relief from disease.

2. SHAMANA CHIKITSA

It is the use of various herbal and classical ayurvedic formulations which pacify the vitiated doshas and thus improve the quality of Rasa and Rakta, thus balancing hormones and helpful in curing Mandala Kushtha.

3. RASAYAN CHIKITSA

It is part of Shamana Chikitsa which is rich in antioxidants, Rejuvenating and has Kayakalpa action which causes and provides relief in Mandala Kushtha.

HERBS USEFUL FOR PITYRIASIS ROSEA

GUGGUL

Guggul (Commiphora wightii) is helpful in managing Vata which enhances digestion and circulatory mechanism. It is helpful in removing Ama from the body and thus balances the tridoshas of the body. Useful in enhancing complexion and in various skin disorders. Decreases the level of cholesterol and relieves inflammation of joints. Guggul is rejuvenative in nature which improves the strength and digestion of the body.

VIDANGA

Vidanga (Embelia ribes) is one of the powerful anti-parasitic herbs which balances Vata and Kapha doshas. It is helpful in easing the movement of the intestine and improves the appetite. Relieves constipation and balances the Vata doshas. Is a great energy booster and tonic thus reducing inflammation. Has antifungal and Antibacterial properties which treat various skin disorders.

KHADIRA

Khadir (Acacia catechu) is helpful in balancing Pitta and Kapha doshas, are useful in all types of skin irritation and in skin itching. Balances the imbalance of kapha doshas in the body. Removes the accumulated toxins from the body, improves digestion and relieves itching and swelling.

DEVDARU

Devdaru (Cedrus deodara) balances the imbalance of doshas and is helpful in various pruritus, infested wounds. It balances Vata and Kapha doshas. Helpful in Skin diseases and relieves Ama (endotoxins). Removes the excess mucus from the lungs. Promotes respiratory health and maintains a clear respiratory tract by boosting property.

HERBAL REMEDIES FOR PITYRIASIS ROSEA BY PLANET AYURVEDA

Planet Ayurveda is an ISO 9001:2015 Certified and US-FDA registered ayurvedic company which adheres to the objectives of all ayurvedic products which are mentioned in Ayurvedic texts. Formulations which are manufactured by planet ayurveda are without any preservatives and chemicals which do not cause any side effects on the human body. Products which are manufactured on the planet Ayurveda are pure and devoid of any adulteration. These products are pure and gluten-free. For Pityriasis Rosea planet ayurveda formulated various herbal supplements which are beneficial in this.

PRODUCTS LIST

1. KAISHORE GUGGUL
2. KHADIRARISHT
3. GLEAMING HAIR, NAIL AND SKIN FORMULA
4. NEEM CAPSULES
5. RECUMIN GEL
6. PITTA BALANCE

PRODUCTS DESCRIPTION

1. Kaishore Guggul

Kaishore Guggul are herbal tablets which are formulated by planet ayurveda using Amalaki (Emblica officinalis) and Guggul (Commiphora mukul), Vidanga (Embelia ribes), Long Pepper (Piper longum) and many more. It is helpful in various skin diseases as it has blood-purifying properties. Removes the toxins from the body and blood. Soothes the inflamed joints and cools the system.

Dosage- 2 tablets twice daily after meals with plain water.

2. Khadirarisht

Khadirarisht is a classic Ayurvedic product which is formulated by planet ayurveda Khadira Twak (Acacia catechu), Gur (Saccharum officinarum), Sheetal Cheeni (Piper cubeba), Lavang (Syzygium aromaticum) and many more. Is helpful in chronic skin diseases which include leprosy. Has a pitta balancing property that reduces dark spots and scars.

Dosage- 2 teaspoons twice daily after meals with plain water.

3. Gleaming Skin, Hair and Nails Formula

Gleaming Skin, Hair and Nails formula are polyherbal capsules which are made by planet ayurveda using Manjistha (Rubia cordifolia), Sariva (Hemidesmus indicus), Ghrit Kumari (Aloe barbadensis) and more. It is helpful in clearing toxins and provides whole nourishment to the skin, hair and nails. Boosts the immune system and prevents various bacterial diseases.

Dosage- 1 Capsule twice daily after meals with plain water.

4. Neem Capsules

Neem Capsules are single herbal capsules formulation which is made by planet ayurveda using a Standardized extract of Neem (Azadirachta indica). It has blood purifying properties, which reduce toxins levels and has antimalarial properties. Manages pimples or acne and minimizes the pores on the skin.

Dosage- 1 capsule twice daily after meals with plain water.

5. Recumin Gel

Recumin Gel is a gel-like formulation which is made by planet ayurveda using ingredients such as Haridra (Curcuma longa), Nee (Azadirachta indica), Jyotishmati (Celastrus paniculatus), Guggul (Commiphora mukul) and many more. It is helpful in improving wounds and controlling the flares of skin diseases, reducing pores, acne and scarring.

Dosage- Apply locally over the affected area.

6. Pitta Balance

Pitta Balance is a polyherbal capsule which is made by planet ayurveda using Giloy Satva (Tinospora cordifolia), JaharMohra Pishti (Natural Calcium Compound), Mukta Pishti (Natural Calcium compounds from pearls) and many more. It is helpful in maintaining Overall health and supports healthy joints. Useful in controlling anger and frustrations.

Dosage- 1 capsule twice daily after meals with plain water.

CONCLUSION

Pityriasis Rosea is a common skin condition which causes raised red color scaly patches on the body. Skin diseases affect the various parts of the skin which causes rashes, inflammation and changes in skin color. It is caused by a virus which begins with a single red and slightly scaly area known as Herald Patch. It is a self-limiting rash which resolves in about 6-10 weeks and further develops smaller scaly oval-shaped patches which resemble a Christmas tree. Pityriasis Rosea comes under Mandala Kushta which is one of the Mahakushta. This disease involves the vitiation of Kapha doshas with dushya Rakta and Mamsa which affects the skin texture and causes physical and psychological disturbances. For this disease, Planet Ayurveda provides a list of products which are helpful in this disease without causing any side effects.