How does pityriasis rosea become infected?

The appearance of dubious spots on the skin, which sometimes itch and flake, is a serious reason to consult a doctor and check for dermatological diseases.

Pityriasis rosea (Giber's disease, roseola exfoliates, pityriasis, pithiasis) is an acute skin disease with specific rashes, a peculiar course and a tendency to seasonal relapses. It manifests itself in the formation of pink spots on the skin of the chest, back, limbs and other parts of the body, located along the lines of maximum extensibility (Langer's lines). Over time, the rashes become like large medallions. From the moment the first maternal plaque (large spot) is detected until the symptoms of the disease completely disappear, 30-45 days pass.

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Causes of pityriasis

Despite the fact that Gibert's disease is very common, the mechanism of the disease is not fully understood. The following factors are believed to play an initial role:

1. Exposure to viruses (type 7 herpesvirus, etc.), bacteria and other infectious agents. This is confirmed by tests that prove the presence of pathogens in the body. Very often, skin disease appears against the background of influenza, acute respiratory infections and other infections.
2. Attachment of allergic reactions.
3. Bites from bedbugs, lice and other blood-sucking insects.
4. Reduced immune defense.
5. Frequent hypothermia and stress.
6. Violation of gastrointestinal functions and metabolism.
7. Introduction of vaccines.

Contraindications and side effects

Do not use ointment or cream if you have hypersensitivity to the ingredients in the composition. Also, external agents are contraindicated in the first trimester of pregnancy (there is insufficient data on the safety of clotrimazole).

After applying the ointment or cream, symptoms of an allergic reaction may occur: redness, irritation, itching. Rashes and severe peeling appear less frequently. In most cases, such effects are caused by fungal toxins, the cells of which are destroyed by the active substance of the drug. Most often, side effects disappear with further treatment. If the negative effect persists or intensifies, then therapy with this drug must be interrupted.

No health hazards have been reported with long-term use of Clotrimazole ointment.

The active ingredient of the drug interacts with a number of other antifungal agents. Nystatin and natamycin reduce the effect of clotrimazole.

Combined use with dexamethasone gives the same result. The antimycotic effect of clotrimazole is enhanced in the presence of the additive E216, used in cosmetics and food products as a preservative and antifungal agent.

Symptoms of pityriasis

Clinical manifestations of pityriasis rosea are caused by exposure to infectious pathogens and the development of allergic reactions. The skin disease is manifested by the following symptoms:

• General weakness, enlarged lymph nodes, elevated body temperature.
• The formation on the body of small pinkish and mauve spots that have a symmetrical shape and appear along Langer’s lines. Rashes appear on the back, limbs, chest, neck, groin and other parts of the body.
• The appearance on the skin of 2-3 bright red maternal plaques (their diameter is 4 cm), dotted with scales. After a week, small pink rashes form from these large spots.
• Dropout spots spread throughout the body and increase in size (their diameter is 1-2 cm), can peel off, and resemble medallions in shape.
• Severe skin itching.
• Increased irritability.

With proper therapy, the symptoms of pityriasis disappear after 5-8 weeks, and the patient fully recovers. Longer therapy is required if the rash has dense nodules, blisters or papules. In exceptional cases, pityriasis rosea turns into eczema, purulent inflammation of the skin, folliculitis, streptococcal infections, etc. develop. The development of complications is facilitated by the patient’s excessive sweating, a tendency to allergies, constant friction of the skin and improper treatment.

Antiviral agents

It was not possible to accurately determine the causative agent of pityriasis rosea, but some studies prove that it is caused by the human herpes simplex virus. Accordingly, local and oral drugs with antiherpetic activity are often used in the treatment of the disease. These are usually medications based on acyclovir, a substance considered most effective in fighting the virus.

Acyclovir

A drug based on acyclovir, which is available in tablet form. Prescribed for infectious processes caused by herpes simplex virus type 1 or 2. When interacting with enzymes, it forms an active compound that blocks the proliferation of pathogenic cells.

The standard dose is 200 mg 4-5 times a day, the duration of treatment is 5 days. Acyclovir is not used in cases of individual intolerance to the components, a tendency to allergic reactions, or under the age of 2 years. The list of side effects of the drug is quite large, ranging from digestive disorders to headaches and hallucinations.

The most common drugs based on acyclovir are Acyclovir, Zovirax, Gerpevir, Panavir.

Most often, tablets are used in the treatment of pityriasis rosea; in advanced cases, injections and infusions are necessary. Antiviral drugs are ineffective against other types of pathogenic microorganisms, so before treatment it is necessary to accurately determine the causative agent of the disease. If there is no result, the drug is discontinued, otherwise it may cause side effects.

Diagnosis of pityriasis

If you find suspicious spots on the skin, you should promptly contact a dermatologist. During a visual examination, the doctor assesses the nature of the rashes, their shape, size, location on the body and is able to make the correct diagnosis. After dermatoscopy, the following studies are additionally carried out: biochemical tests of blood and urine, RMP (microprecipitation reactions with antigens), skin scrapings from injured areas.

A more complex diagnosis is carried out if the skin disease lasts more than six weeks. In these cases, discharge from the affected lesions is sent for bacterial culture. A biopsy and subsequent histological studies will help make the correct diagnosis. In order to distinguish Zhiber's disease from other types of lichen, toxicerma, psoriasis, complicated syphilis and other pathologies, fluorescent diagnostics are carried out, scrapings are checked for the presence of pathogenic fungi, RPR tests are done for syphilis, etc.

The therapeutic effect of clotrimazole

The skin and mucous membranes are affected by various species and strains of microscopic fungi belonging to the group of dermatophytes. They feed on keratin in the epidermis, nails and hair. The genera Epidermophyton, Trichophyton, Microsporum, and representatives of the genus Candida have pathogenic properties. The latter cause thrush and affect the skin and internal organs of a person. Yeast-like microorganisms of the genus Malassezia cause pityriasis versicolor (pityriasis versicolor).

Action of clotrimazole:

• antifungal
  - against Trichophyton rubrum, Epidermophyton, Microsporum, Candida albicans, Malassezia folliculitis;
• antiprotozoal
  , mainly trichomonacid, - the ability to suppress the causative agent of trichomoniasis (the simplest organism Trichomonas);
• antibacterial
  - against strains of bacteria staphylococci and streptococci.

The fungistatic effect of clotrimazole is expressed in growth retardation and reduction in the reproduction of microscopic fungi, which ultimately leads to their death. Fungicidal effect - suppression of the germination of parasite spores in the skin, nails, mucous membrane, which completely blocks the development of infection. What effect will be achieved depends on the type and strain of the microbe, the concentration of the active ingredient.

Resistance is rarely developed in fungi against which clotrimazole is used.

The causative agents of mycoses parasitize in the upper layer of the skin. Clotrimazole acts on microorganisms directly at the site of the lesion. The medicine penetrates the epidermis, but is not absorbed into the blood through the skin. If the active substance enters the systemic bloodstream, it is destroyed in the liver. Decomposition products are excreted through the gastrointestinal tract and kidneys.

Pityriasis rosea in pregnant women

Pityriasis occurs more often in women than in men. It is especially dangerous when the skin disease occurs in pregnant women. If you notice any rashes, it is important to immediately visit a dermatologist and undergo treatment. It is unacceptable to risk the baby’s health and expect the plaques to disappear on their own. If the disease is not treated, then bacterial infections appear, which are much more difficult to deal with.

If a pregnant woman has not been diagnosed with pityriasis rosea, it is nevertheless important to adhere to the following recommendations:

• clothing made from cotton and linen is preferable to synthetic and woolen fabrics
• limiting heavy physical activity
• For hygienic purposes, use only warm water
• timely moisturizing of damaged skin areas

Authorized Products

• Bran bread, whole grain bread, bran bread.
• It is advisable to cook soups in vegetable broth with the addition of cereals and permitted vegetables. During an exacerbation, meat and fish broths should be excluded or secondary broth should be used.
• Second courses are prepared from veal, beef, chicken or turkey (meat according to permission and individual tolerance). They are prepared in pieces, boiled or baked. It is also better to bake minced meat products using a minimum amount of vegetable oil.
• Any fish is allowed (dietary and fatty - mackerel, cod, salmon, herring), if its consumption is approved by a doctor and it does not cause allergies. The fish is stewed, boiled or baked. If tolerated well, fish should be present in the diet daily, replacing meat.
• Any vegetables and herbs (as tolerated) up to 600 g per day. For some diseases, certain vegetables are excluded, but the list of them is sufficient to diversify the diet. Considering that the vitamin value of fresh vegetables is greater, most of them are consumed fresh with vegetable oils. Out-of-season greenhouse vegetables should be excluded or limited.
• Include allowed fruits in the menu daily (up to 500 g). Give preference to locally grown fruits.
• Eat foods high in dietary fiber: bran, prunes, gooseberries, dates, figs, raisins and dried apricots, unless they are prohibited due to your illness.
• Chicken eggs and quail eggs - boiled; they are excluded if you are allergic to chicken protein.
• Low-fat dairy products and cottage cheese. Give preference to natural kefir and yogurt with bifidobacteria (dyes and preservatives).
• All grains are allowed, but preference should be given to whole grains rather than processed flakes. Moreover, it is not permissible to consume instant porridges with preservatives and artificial flavor substitutes.
• Pasta products are allowed from durum wheat.
• Include vegetable oils, using them in prepared dishes and alternating.
• The preferred drinks are weak tea with milk, green tea, herbal infusions (in the absence of allergies to herbs), compotes, natural juices, and rosehip infusion.

Table of permitted products

Treatment of pityriasis

When a patient is diagnosed with Gibert's disease, the dermatologist develops an individual treatment regimen to avoid dangerous complications. There is an opinion that pityriasis rosea will go away on its own in a few weeks. As a result, complications arise, and the patient comes to the dermatologist with an advanced form of the disease.

Drug treatment includes the following medications:

• antihistamines that relieve the patient from itching, swelling and redness on the body
• corticosteroid, desensitizing and antipruritic ointments. Medicinal compositions containing betamethasone, hydrocortisone, etc. are applied to the affected skin and lightly rubbed in. The medications eliminate rashes, get rid of peeling, and effectively restore the skin.
• drying agents containing zinc to accelerate skin healing
• Broad-spectrum antibiotics are indicated in cases where a bacterial infection is associated with pityriasis rosea. It is unacceptable to start taking antibacterial drugs on your own, since they are selected individually, taking into account laboratory tests.
• antifungal medications: drugs containing clotrimazole and other active substances are prescribed topically in the form of gels and ointments
• antiviral drugs containing acyclovir and other active components. Dermatological tests have confirmed that if antiviral drugs are prescribed in combination with antibiotics from the first days, the patient quickly recovers.
• neutral water-shaken preparations Dermatologists prescribe pharmacy talkers containing zinc oxide, menthol and anesthesin to patients with pityriasis rosea. These products relieve itching and pain in damaged areas and speed up recovery.
• iodine is an aggressive, but extremely effective remedy. Injured skin is treated with iodine in the morning and evening. Initially, the skin begins to peel off more actively, but then there are no extra scales left on it. Not all experts recommend that their patients cauterize damaged areas with iodine, since this drug can be harmful if used incorrectly.

Recommendations for patients

During the treatment period, the patient is recommended to adhere to the following recommendations:

1. Follow a hypoallergenic diet: avoid nuts, citrus fruits, chocolates, honey, etc. Products containing artificial colors should be excluded from the menu. It is worth limiting the consumption of fried foods, carbonated drinks, fast food, strong alcohol and coffee.
2. Limit water treatments within reasonable limits and give preference to the shower.
3. Refuse to use aggressive hygiene and cosmetic products for the body. Gels and other detergents should not dry out the skin.
4. Give preference to underwear made from natural fabrics.
5. Moderate sunbathing - ultraviolet light helps the skin recover faster.
6. Follow the recommendations of a dermatologist, apply to the skin only products recommended by a specialist.
7. Folk remedies can be used only after consultation with your doctor.

Active ingredient and base of ointment and cream

Clotrimazole is the active ingredient of a large group of ointments and creams. The active ingredient is one of the first synthetic derivatives of the effective antifungal (antimycotic) drug imidazole. The percentage of clotrimazole in the ointment is 1% (1 g of active ingredient per 100 g of external agent).

Often in everyday life, medicinal creams and gels are called ointments. Soft dosage forms differ significantly in the composition of auxiliary ingredients. Russian-made ointments usually use Vaseline; creams contain water and alcohols. The bases are not the same, so the speed and depth of penetration of the active substance into the skin is different.

The auxiliary ingredients of the ointment form its base. These are Vaseline, wax emulsion, polysorbate-80, castor oil. This base provides a longer antimycotic effect. The downside of Vaseline is a greasy film on the skin, a “greenhouse” effect of the product in heat, in hot weather.

The content of the active ingredient in the cream for external use is 1 or 2%. This product is less greasy than ointment and does not stain linen and clothes much less. The cream is easier to distribute on the skin, but the depth of penetration and duration of action is slightly less compared to ointment.

Menu (Power Mode)

From the list of allowed foods, you can create a varied menu, alternating different protein and cereal dishes throughout the week. Remember, vegetables or fruits should be included at every meal. You should enrich your dishes with bran, vegetable oils, seeds and nuts (if they are not contraindicated for you). Use cold-pressed vegetable oils in salads. Fruits can be used for snacks. If fermented milk products are indicated for you, then include them in your diet every day.

Fully or partially limited products

• For almost all skin diseases, highly extractive dishes (broths) are excluded.
• Fatty types of meat and poultry, and for some diseases, red meat and chicken.
• Fried foods, smoked meats, pickled vegetables, canned food (meat and fish), sausages, any semi-finished products (due to the content of preservatives). Sausages, sausages, ham, pates also contain preservatives and dyes.
• For all skin diseases, during the period of exacerbation, simple carbohydrates (sugar, sweets, jam, cakes, jams, sweet pastries, confectionery with cream) are excluded.
• Strong tea, coffee, cocoa.
• The use of hot sauces (vinegar, ketchup, mayonnaise), spices and alcohol is prohibited.
• If tolerance is poor, you should limit legumes and mushrooms, as foods that are difficult to digest and cause flatulence.

Table of prohibited products