Updates from Medicine
Pityriasis rotunda. A clinical study in Jordan: experience of
, Awad Al-Tarawneh
, and Hussein Odeibat
Faculty of Medicine, Mutah University,
Karak, Jordan, and
Dermatology, Venereology and Laser,
Laser King Hussein Medical Center,
Faculty of Medicine
Background Pityriasis rotunda is a rare skin disease characterized by the presence of multiple,
round or oval, sharply demarcated hyperpigmented scaly patches. It has been described in
Japan, South Africa, and in some other countries. The cause of pityriasis rotunda is usually
idiopathic but may be associated with certain internal malignancy or systemic diseases.
Objective The aim of this study is to describe this rare entity in Jordan in a retrospective
study during the last 10 years. Jordan, as a Middle Eastern country, had no previous
reports about this rare disease. In addition, the intention was to report any systemic
association with the disease. Some of the cases were examined by dermoscopy. No
previous reports documented dermatoscopic features of the disease.
Results We could report 23 cases during the last 10 years. Eighteen cases were females
and ﬁve males, in an age range of 9–38 years. There were three familial cases. The
dermatoscopic ﬁndings were well demarcated, hyperpigmented with brownish patches with
polygonal scales. These scales were more deﬁned, not homogeneous in color, and
separated from each other by paler stria.
Conclusions The cases of the study seem to indicate the rarity of the disease in Jordan.
Our case ﬁts neatly into the benign form of the disease with lack of association with any
Pityriasis rotunda is a rare disease characterized by large,
round or oval, pigmented, sharply deﬁned patches with no
It is an ichthyosiform scaly disease, ﬁrst
described by Toyama in Japan in 1906.
It was described ini-
tially as pityriasis circinata and acquired pseudoichthyosis, as it
is characterized by hyper- or hypopigmented, circular, and shar-
ply deﬁned patches of dry ichthyosiform scaling.
rotunda mainly occurs on the buttocks, thighs, abdomen, trunk,
and upper and lower extremities. The size of patches is usually
2–3 cm in diameter but sometimes much larger, up to 14 cm.
Colors of patches in pityriasis rotunda range from pink to light-
brown. In dark-skinned patients, the patches are usually darker
than surrounding skin; however, in patients with light skin, these
patches are hypopigmented compared to the surrounding skin.
Pityriasis rotunda remains an unusual dermatosis, and the
pathogenesis of the disease has not yet been identiﬁed. Grimalt
proposed two types for the disease.
Type I is seen mainly in blacks
and Asians and is often associated with internal disease or malig-
nancy but no family history. Type II occurs more in Caucasians and
in patients less than 40 years, and often in several members of the
same family. To date, no cases of type II pityriasis rotunda have
been associated with internal malignancy or systemic diseases.
Pityriasis rotunda is a rare disease. It has been described
in the Far East (Japan and China), Africans, and African-Ameri-
cans. In addition, cases of pityriasis rotunda have been reported
in Italy, Tanzania, India, and others.
Jordan, as a Middle Eastern country, had no previous reports
about this rare disease. So, we aim to report our experience
about pityriasis rotunda in our community in a retrospective
study during the last 10 years and to document if there is any
systemic association with the disease. In addition, during the
last 3 years, all cases were examined by dermatoscopy looking
for speciﬁc features for the disease.
Patients and methods
Twenty-three patients presented to the Dermatology Clinic at
King Hussein Medical Center (the main medical center in
Jordan), Karak Teaching Hospital, and Mutah University
Medical Centers from 2007 to 2017. These cases presented to
the clinics for evaluation of asymptomatic skin lesions on their
trunks or extremities. A detailed history was taken from patients
including the age, sex, and the duration of the lesions. The
location of the patches and the colors of the patches were
documented. In addition, the patients were asked if there was
any history of pain or itching. Detailed history of their health,
ª 2018 The International Society of Dermatology International Journal of Dermatology 2018, 57, 759–762