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Pityriasis Rosea in Pregnancy

This common illness can have deleterious effects when it occurs early in pregnancy.

Pityriasis rosea (PR), an acute illness marked by a papulosquamous eruption, mainly affects children and young adults. Some studies implicate a viral cause, especially a primary or reactivated infection with human herpes viruses (HHVs) 6 and 7, but the evidence is inconclusive. Although the disease is self-limited, usually resolving after 6 to 8 weeks without any apparent residua, one concern is its effects in pregnancy. Investigators in Italy examined 38 women who developed PR during pregnancy.

Of these women, five miscarried (13%), but the miscarriage rate was 62% in those who developed PR in the first 15 weeks of pregnancy. Hypotonia and weak motion were common in the infants of women who developed PR between 16 and 20 weeks’ gestation; only 33% of these pregnancies produced healthy infants at delivery. Nine women (24%) had premature deliveries. However, all premature neonates survived and were healthy at the time of the report.

PR was exceptionally severe in all the mothers who miscarried. These women had longer courses, more-widespread skin lesions, and more frequent than usual systemic complaints, such as headache, insomnia, anorexia, and fatigue. Detailed study of one woman who miscarried indicated active infection with HHV-6 in both the mother and the fetus.

Comment: This report demonstrates a high risk for fetal loss and for neonatal weakness and hypotonia in pregnancies affected by PR during the early weeks of gestation. Clinicians should alert women who develop PR in pregnancy about the potential risks of this presumed viral infection, although there is no known effective intervention to prevent these complications. Nor is there a clear way to avoid this illness. The detailed study of the miscarried fetus suggested reactivation of HHV-6, rather than primary infection, based on observation in the mother of specific serum IgG antibody but no IgM antibody.

— Jan V. Hirschmann, MD

Published in Journal Watch Dermatology May 30, 2008

Citation(s):

Drago F et al. Pregnancy outcome in patients with pityriasis rosea. J Am Acad Dermatol 2008 May; 58:S78.

• Medline abstract (Free)

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Review and add to remarks on this article

• pityriasis rosea and pregnancy
  gulnar aghaeva, university teacher, 29 Jul 2009 2:53 PM EST
  I had this disease,for a long time.I had 2 spots in winter on the back of knees, then in summer... [more]
• pityriasis rosea and pregnancy
  Jan V. Hirschmann, MD, JW Dermatology summary author, 30 Jul 2009 1:56 PM EST
  It seems unlikely that pityriasis rosea caused the problems described. The duration of the rash in pityriasis rosea usually lasts... [more]
• pityriasis rosea and pregnancy
  gulnar aghaeva, university teacher, 4 Aug 2009 7:36 AM EST
  thank you so much for the attention to my remark. wish you success in your valuable work.
• Pregnant and diagonised with PR, need help
  Worried mom, 10 Sep 2009 1:59 PM EST
  Dr Jan,
  
  Thank you for your work on PR.
  
  I was recently diagnosed with PR (for about 5 weeks) and... [more]
• Pitrriasis rosea & Pregnancy
  GJ Foye MD, 27 Oct 2009 2:05 PM EST
  Given the above data, which is worisome, should a healthcare worker in the delivery rooom refrain from work if they... [more]
• Pityriasis Rosea in Pregnancy
  Gwen Lewin, 17 Feb 2010 2:49 PM EST
  I developed PR when I was about 6-7 weeks pregnant (after seeing a heartbeat in a sonogram at 6.5 weeks).... [more]
• 1st trimester and PR
  Susan Cohen, 14 Jun 2010 1:57 PM EST
  Of the babies born to mothers who contracted PR in their first trimester of pregnancy, has there been any follow-up... [more]
• Pitrriasis rosea & Pregnancy
  Kasey J. Bouchard, 11 Aug 2011 1:13 PM EST
  Specialty: Other Specialty
  In case other pregnant women are googling this like my partner was: My partner was pregnant in the fall of... [more]

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