Rashes & Inflammation

Pityriasis Lichenoides - Symptoms, Causes & Treatment

Medically reviewed by Dr. Anand S. Urhekar, MD, MD Pathology, Clinical Advisor · Last updated July 2026

An uncommon inflammatory skin disorder producing recurring crops of small red or brown scaly papules. The acute form (PLEVA) has rapidly appearing spots that ulcerate and crust, while the chronic form (PLC) produces slower-evolving scaly papules that leave pale or dark marks. It mostly affects children and young adults.

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Quick Answer

Pityriasis lichenoides causes recurring crops of small scaly red-brown papules, with an acute ulcerating form (PLEVA) and a milder chronic form (PLC). It affects mainly children and young adults, is not contagious, and usually resolves over months to a few years. Treatment options include topical steroids, oral erythromycin or tetracyclines, and narrowband UVB phototherapy.

Symptoms

  • Crops of small red-brown papules with a fine mica-like scale
  • Lesions at different stages simultaneously
  • Ulceration, crusting and scarring in the acute PLEVA form
  • Pale or dark marks after healing
  • Trunk and limbs; usually little itch

Causes & Risk Factors

  • Believed to be an immune reaction, possibly to infection
  • Associations reported with Epstein-Barr virus, toxoplasma and others
  • Considered a clonal T-cell disorder in some cases
  • Most common in children and young adults

Treatment & Management

  • Topical corticosteroids for symptomatic lesions
  • Oral erythromycin (particularly in children) or tetracyclines
  • Narrowband UVB phototherapy
  • Methotrexate for severe or ulceronecrotic disease
  • Periodic review, as rare progression to lymphomatoid conditions is described

When to See a Doctor

See a doctor for recurring crops of spots that ulcerate or scar, for fever with widespread lesions, or if lesions are not settling after several months — biopsy usually confirms the diagnosis.

Frequently Asked Questions

Is pityriasis lichenoides contagious?

No. Despite following an infection in some cases, the rash itself cannot be passed to others.

How long does it last?

It typically runs a relapsing course over several months to a few years before settling. The chronic form (PLC) tends to persist longer but is milder and rarely scars.

Medical References

Information on this page is sourced from and verified against reputable medical resources:

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Medical Disclaimer: This information is for educational purposes only and is not intended as medical advice. The content on this page should not be used to diagnose or treat any health problem. Always consult with a qualified healthcare professional for proper medical evaluation, diagnosis, and treatment of your condition.