Herald patch followed by rash is characteristic of:

(a) Psoriasis
(b) Lichen planus
(c) Pityriasis rosea
(d) Dermatophytosis

ANS- (c) Pityriasis rosea

This is an acute, self-limiting exanthem that particularly affects young adults and occurs worldwide, with a slight female predominance.

It usually presents in spring and summer, although no infective agent has been identified and its aetiology is unknown.

It is characterised by the appearance of a ‘herald patch’, an oval lesion (1–2 cm) with a central pinkish (salmon-coloured) centre, a darker periphery and a characteristic collarette of scale.

It is followed 1–2 weeks later by a widespread papulosquamous eruption, which is typically arranged in a symmetrical ‘fir tree’ pattern on the trunk.

Individual lesions also have a collarette of scale. An inverse variant with flexural involvement can occur.

Mucosal involvement is rare.

There is a small risk of recurrence. Symptomatic relief can be achieved with emollients and mild topical glucocorticoids.

Post-inflammatory hyperpigmentation can supervene, particularly in darker skin types.

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