- Mild constitutional symptoms. Mild pruritus.
- Occasionally they are multiple and seen in 50% cases.
- Wide spread pink papules
- Appear 5-15 days after herald patch.
- Vesicular, pustules and purpuric lesions are also seen.
- These symptoms usually persist for 6-8weeks.
- Spontaneously resolve. Heal with hypo/hyperpigmentation.
- Inverse PR –lesions are seen in the axilla and inguinal areas.
- Congestion of oral mucosa, nose.
- Face, palms and soles usually spared.
- The precise cause is not known.
- Probably viral infections – HHV-7 &HHV-6 play a role.
- Some drugs – Metronidazole, gold, barbiturates, clonidine, captopril, isotretinoin, imatinib can cause PR like eruption.
- Cell mediated immunity may be involved with a presence of activated CD4 + / HLA – DR+ in the epidermal and dermal infiltrate in association with Langerhans cells(CD1a+).
- Commonly seen in children and young adults (35 years).
- Slight female predominance.
- No racial predilection
- Worldwide
- Seasonal variations – peak in the spring and fall.
