Herald lesion

Herald Patch or Herald Lesion is a primary lesion that often precedes the full manifestation of Pityriasis Rosea, a common skin condition. The herald patch is characterized by a single, large, round or oval, pink or salmon-colored patch that appears on the skin. It is typically larger than subsequent lesions that may appear later and is often mistaken for ringworm (Tinea Corporis) or eczema (Dermatitis) due to its appearance.

Symptoms and Identification

The herald patch is usually solitary and can range in size from 2 to 10 centimeters. It has a well-defined border and a slightly scaly, raised edge. The center of the patch may appear more faded or clear as it ages. This lesion is most commonly found on the trunk of the body but can also appear on the neck, upper thighs, or upper arms. After the appearance of the herald patch, smaller, similar-looking lesions tend to spread in a Christmas tree pattern, especially on the back. This pattern is highly indicative of Pityriasis Rosea.

Causes

The exact cause of Pityriasis Rosea and the herald patch is unknown, but it is believed to be viral in nature. Some studies suggest a link to human herpesvirus 6 and 7, but this connection is not definitively established.

Diagnosis

Diagnosis of a herald patch is primarily clinical, based on its appearance and the presence of characteristic symptoms. In some cases, a skin biopsy or other tests may be performed to rule out other conditions such as Syphilis, Tinea Corporis, or Nummular Eczema.

Treatment

Treatment of the herald patch and Pityriasis Rosea is generally symptomatic. The condition is self-limiting and usually resolves without treatment within 6 to 8 weeks. If itching is severe, topical steroids or antihistamines may be prescribed to provide relief. Exposure to sunlight has also been shown to hasten the resolution of lesions in some cases.

Prognosis

The prognosis for individuals with a herald patch and Pityriasis Rosea is excellent. The condition typically resolves on its own without leaving scars. However, dark-skinned individuals may experience temporary hyperpigmentation or hypopigmentation at the sites of the lesions.

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