Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • herald patch
  • pruritus
  • age 10 to 35 years
  • 2- to 12-week duration
  • scale
  • located on trunk and upper extremities
  • located on face, palms, soles, mucosa
  • fir-tree pattern distribution
  • acute to subacute recurrent skin eruption

Other diagnostic factors

  • 2-week timing between herald patch and new lesions
  • female sex
  • prodromal symptoms
  • pigmentary alteration (severe cases/dark skin color)

Risk factors

  • age 10 to 35 years
  • female sex

Diagnostic investigations

Investigations to consider

  • skin biopsy
  • antistreptolysin O titers
  • potassium hydroxide (KOH) prep microscopy or fungal culture
  • RPR/VDRL
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Daniela Kroshinsky

Director of Inpatient Dermatology

Associate Professor of Dermatology

Massachusetts General Hospital

Harvard School of Medicine

Boston

MA

Disclosures

DK declares that she has no competing interests.

Peer reviewers VIEW ALL

Chief of Dermatology

Brookdale Hospital

Brooklyn

NY

Disclosures

EL declares that she has no competing interests.

Fellow

Dermatology

University of Michigan

Ann Arbor

MI

Disclosures

LS declares that he has no competing interests.

Consultant Dermatologist

Department of Dermatology

Queen's Medical Centre

Nottingham University Hospitals NHS Trust

Nottingham

UK

Disclosures

JE declares that he has no competing interests.

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