Pityriasis Circinata: Causes, Symptoms & Treatment

Pityriasis circinata is a rare skin condition, but its visible changes often cause patients to panic. Its symptoms are similar to other diseases, so a visit to the doctor is essential to clarify what is causing it. Pityriasis circinata has been described in the Americas, Africa and Australia, but also occurs very rarely in Europe. Little is really known about this disease, and the medical literature mentions it very little. Some medical professionals believe it is only symptoms of another, more serious disease.

What is pityriasis circinata?

Pityriasis circinata, also known in the literature as pityriasis rotunda, is a typical skin lesion whose cause is not yet fully understood. Accordingly, it may be caused virally or bacterially. It is generally understood to be an allergic reaction, but some researchers take the approach that serious, organic causes also exist. A clinical study was able to classify two types of pityriasis circinata. Type I occurs primarily in African and Black American men over the age of 60. The skin changes are associated with other organic diseases. Type II, in contrast, occurs in young men under 40. Here, the physicians have not yet been able to find any evidence of parallel diseases. However, an accumulation of pityriasis circinata was shown among relatives.

Causes

The causes are unknown to date. Viral, bacterial, or genetic causes may be considered. Studies show a type I link to liver cancer and stomach cancer. Heart problems and other organ failure are also discussed as causes in the medical literature. This may be an indication of impaired metabolism, where organ failure causes certain proteins to no longer be properly distributed in the bloodstream. This makes the skin vulnerable to the outside world. However, type II is not associated with any diseases. The clustering in families may indicate a genetic cause. Some researchers also argue that pityriasis circinata can be attributed to poor or inadequate nutrition. Although many studies have shown that pityriasis circinata is associated with other diseases, a precise link has not yet been adequately established. However, most medical experts rule out a contagious disease. A virus could not be isolated so far. Also, sexual transmission has not been proven, as is the case with syphilis, which has a similar course.

Symptoms, complaints, and signs

Pityriasis circinata includes several symptoms. There are skin changes that appear as rashes. These are mainly found on the legs, trunk, and arms. The rash is often circular and stands out from the surrounding skin. The surface is scaly and the underlying skin darkens, making the round skin lesions very easy to see. The areas itch and are easily inflamed. Symptoms may also appear on other parts of the body over time. Patients report that they also felt a general malaise during the disease. Medical literature mentions headache and migraine in particular, but also a raw throat and following sore throat. When the skin lesions were formed, fever could also be detected.

Diagnosis and course of the disease

The physician can easily make a diagnosis of pityriasis circinata based on the visible skin changes. To avoid confusion with other diseases, he will perform blood tests. Syphilis patients have similar symptoms, so he can use these tests to rule out this disease. In a more advanced stage, a biopsy of the skin tissue is also performed in the laboratory. Since some physicians associate pityriasis circinata with internal organ disease, to be on the safe side, the physician will also arrange for the patient to be referred to an internist, who can provide clarification as to whether stomach or liver cancer may be present. Cardiac examinations will also be performed.

Complications

In pityriasis circinata, affected individuals suffer from a number of different skin complaints. Primarily, this involves rashes on the skin and, in general, changes on the skin. These have a very negative effect on the aesthetics of the affected person and can significantly reduce them.This leads to inferiority complexes or reduced self-esteem. Children in particular may experience severe teasing or bullying due to pityriasis circinata, causing them to suffer from psychological symptoms or depression. General malaise also occurs due to the disease. Patients suffer from fever and severe sore throat. Pain in the head or a permanent itching of the skin can also occur and has a very negative effect on the quality of life of the affected person. In addition, however, pityriasis circinata can indicate complaints of the internal organs, so that these must also be examined. The treatment of this disease is carried out with the help of medications. Complications do not occur in this process. However, sufferers rely on prolonged treatment to fully treat all the symptoms of the disease.

When should one go to the doctor?

If there is any change or abnormality in the appearance of the skin, a doctor should be consulted for an evaluation of the symptoms. If rashes, ulcers, itching, or open sores develop, clarification of the cause is needed so that a treatment plan can be made to alleviate symptoms. Circular rashes are characteristic of pityriasis circinata. These are usually located on the arms, legs or trunk. Scaly skin, discoloration or general malaise should be investigated and treated. If the abnormalities spread or increase in intensity, a visit to the doctor is necessary. If, in addition, there are complaints such as headaches, sore throat or a feeling of tightness in the throat, a doctor is also needed. An increased body temperature, impaired phonation or concentration and attention deficits should be discussed with a doctor. If food intake is refused due to the symptoms or if an unwanted weight loss is evident, the affected person requires medical care. A physician should be consulted if migraines occur or psychological problems develop. Withdrawal behavior, reduced self-esteem, a decrease in well-being, and apathy in everyday life indicate health problems. If there are increased interpersonal irregularities, conflicts or if the affected person suffers from the skin changes, a doctor should be consulted.

Treatment and therapy

Since the cause of the disease is not yet known, no form of treatment exists. Therefore, medical professionals try to treat the skin lesions directly. After a successful diagnosis of pityriasis circinata, examinations for liver and stomach cancer or other diseases in the body follow. The skin itself can be treated by the doctor according to the symptoms. The doctor will mainly use anti-inflammatory agents and also stop the itching. So far, mainly agents are used that have also shown positive results with similar symptoms. These include salicylic acid and lactic acid-based agents. Lyes, as they are also soapy water, are perceived by many patients as unpleasant and irritate the diseased skin. The physician can prescribe alternative cleansing preparations. For larger skin lesions, antihistamines are prescribed, which have also shown positive effects. Complete treatment is not currently possible. Even after the skin symptoms subside, in rare cases they may reappear after some time. The skin lesions regress after three to twelve weeks.

Outlook and prognosis

Pityriasis circinata occurs relatively rarely as a skin disease in Europe. A detailed differential diagnosis is important for a reliable prognosis. This is because some variants of pityriasis circinata appear to occur more frequently in association with cancers such as leukemia, liver cancer, or gastric cancer. What is clear, however, is that there are two different types of pityriasis circinata. So, if there are almost circular shaped, light or dark pigmented, as well as scaly skin areas on the trunk or extremities, caution is advised. It is obviously not sufficient to diagnose only a skin disease in the presence of pityriasis circinata. Rather, a possibly undetected cancer must be excluded with certainty. It is unclear whether this skin disease is always an indication of a cancer focus, or whether pityriasis circinata can also occur independently of malignant neoplasms.It is also not known whether pityriasis circinata is a variation of ichthyosis vulgaris. For the prognosis, this means that physicians cannot make any definite statements without further diagnostics. It is also problematic that so far there is no causal therapy for the treatment of pityriasis circinata. The only way to cure this skin disease is to look for an internal disease as a possible trigger. However, purely symptomatic treatment with lactic acid or salicylic acid preparations and topical retinoids is feasible.

Prevention

It is difficult to recommend prevention when the causes of pityriasis circinata are still unknown. In general, a healthy lifestyle and diet prevent many diseases. Regular exercise and daily gentle cleansing of the skin. According to current knowledge, pityriasis circinata is rather a symptom of serious, internal organ diseases, especially in men over 60 years of age. A healthy body is particularly preventive in this case. Young men who have pityriasis circinata in their relatives need to check their skin regularly and have blood tests at the Atzt.

Aftercare

Affected individuals have few options for follow-up care in most cases of pityriasis circinata. For this reason, affected individuals should ideally seek medical attention at the first signs and symptoms of the disease to avoid further complications or other conditions that could reduce quality of life. Early diagnosis usually has a very positive effect on the further course of the disease. The treatment itself is usually carried out with the help of various medications, although creams or ointments can also be used to alleviate the symptoms of pityriasis circinata. Affected persons should pay attention to a correct application and the given dosage of the medication in order to fight the disease. Furthermore, the skin should be particularly well cared for and protected to prevent infection or inflammation. In the event of changes in the skin, a medical professional should be contacted immediately in order to detect and treat further damage at an early stage. As a rule, the further course of pityriasis circinata depends strongly on the time of diagnosis, so that in the process no general prediction can be made about the further course or about the life expectancy of the affected person.

What you can do yourself

As a rule, pityriasis circinata cannot be treated by self-help measures, so the affected person is always dependent on medical treatment to limit the symptoms and discomfort of this disease. Unfortunately, the disease has not been widely researched, so treatment options are severely limited. However, pityriasis circinata requires regular checkups and blood tests to avoid further complications. Taking antihistamines can also relieve symptoms and should be done regularly. Likewise, regular cancer screenings should be performed for pityriasis circinata to diagnose and treat cancer in the liver or stomach at an early stage. Whether there is a decreased life expectancy due to the disease cannot be generally predicted. In most cases, however, the skin symptoms disappear again after a few weeks. If pityriasis circinata causes psychological upsets or depression, discussions with friends and family often help, and contact with other sufferers of the disease can also prove very useful. This often results in an exchange of information.