the name pr was chosen because the lesions are pink ( rosea ) scales ( pityriasis ) . pr is a common acute , self - limited skin eruption that typically begins as a single thin oval scaly plaque on the trunk (  herald patch ) and is typically asymptomatic . within several days to 3 weeks the initial lesions are followed by the appearance of numerous similar - appearing smaller lesions located along the lines of cleavage of the trunk ( a so - called christmas tree pattern ) . the primary plaque of pr , or herald patch , is seen in 50 - 90% of cases . it is normally well demarcated , 2 - 4 cm in diameter , oval or round , salmon colored , erythematous or hyperpigmented ( especially in individuals with darker skin ) , and demonstrates a fine collarette scale just inside the periphery of the plaque . many atypical forms of the disease have been reported in the literature [ 3 , 4 ] . we report on a 28-year - old woman in the 38th week of her first pregnancy , otherwise healthy , who presented in our outpatient clinic . she complained on scaly patches with peripheral collarette scaling mostly over the upper trunk and thighs accompanied with light itching . the patient was treated with aflumycin cream ( prednisolone 0.5% , gentamycin sulphate 0.1% ) without response before she came to our clinic . drug exposure before skin eruption was excluded in both cases . upon examination of the female patient , a skin rash consisting of oval - shaped salmon - colored patches and papules , up to 1.5 cm in diameter , surrounded by light white scales located on her neck , chest , thighs and upper limbs was noticed ( fig . 1 ) . a larger oval shaped lesion on the left thigh (  herald patch ) had appeared a few days before the generalized rash showed . examination of her husband revealed a similar rash consisting of red - pink oval - shaped plaques surrounded by light scales localized on his neck and upper limbs ( fig . 2 ) . laboratory tests including blood count and liver function were within normal values . a biopsy from the husband 's skin showed mild spongiosis and superficial perivascular mononuclear infiltrate with focal extravasated erythrocytes , compatible with pr ( fig . clinical follow - up for both patients showed that the rash resolved without treatment after 4 weeks . the diagnosis was confirmed according to published diagnostic criteria : peripheral collarette scaling with central clearance on at least two lesions . an association with human herpesvirus 6 and 7 ( hhv-6 and hhv-7 ) has been reported but remains controversial . numerous studies over the past 50 years have explored various pathogens as possible causes of pr . these pathogens included numerous bacteria , fungi , and , most notably , viruses . according to a study by drago and colleagues [ 5 , 6 ] most recent pr etiologic and pathogenetic studies have been focused on two ubiquitous hhvs , hhv-7 and hhv-6 . another study by drago and colleagues   found such virions in lesional skin from pityriasis rosea patients . in this study , human herpes virus particles in various stages of morphogenesis the incidence of occurrence of 2 or more cases in the same household is small compared with the total number of cases of pr . niles and klumpp , in their own review , reported 35 cases of pr in different households , 6 of them were couples ( 3 cases ) . another report by miller   presented 3 cases of pr in one family having been diagnosed within 6 weeks . in conclusion , in our report we describe an additional case of pityriasis rosea occurring simultaneously in a couple . this case concerning a couple is an important one as it supports the infectious etiology hypothesis of the disease .
pityriasis rosea is an acute , self - limited papulosquamous dermatosis of the trunk and extremities . 
 many atypical forms of the disease have been reported in the literature [ ahmed et al . 
 : clin exp dermatol 2000;25:624626 ; imamura et al . : dermatologica 1985;171:474477 ] . 
 it is rare to find pityriasis rosea in multiple family members ( within a household ) at the same time . 
 there have been only 4 reported cases where a couple has contracted pityriasis rosea simultaneously [ miller et al . : 
 arch derm syphilol 1941;44:66 - 68 ; niles et al . : 
 arch derm syphilol 1940;41:264 ] .