An unusual case of pityriasis rosea Gibert

Pityriasis rosea Gibert typically follows a recognizable clinical course. However, some cases may pose diagnostic complexities due to their atypical features. A 71-year-old patient with a history of arterial hypertension and type 2 diabetes, presented at the dermatology department with persistent skin lesions over the past 4 weeks. The skin lesions were initially located on the forearms and lower legs, later spreading to the trunk and head. The patient did not associate the onset of the lesions with any specific trigger. Dermatological examination revealed numerous papular-erythematous-oedematous lesions of ambiguous character located on the head, trunk, and upper and lower limbs, accompanied by massive bilateral blepharedema. Laboratory investigations revealed deviations related to the systemic diseases of the patient inter alia normocytic anaemia, elevated creatinine and prostate-specific antigen (PSA) concentration and proteinuria. A skin biopsy dispelled doubts and led to the diagnosis of pityriasis rosea Gibert. Untreated kidney disease could have potentially led to the atypical course of the dermatosis. Treatment with topical steroids resulted in the gradual resolution of skin lesions. This case contributes to the body of knowledge surrounding pityriasis rosea Gibert by highlighting the diagnostic challenges associated with atypical presentations. The histopathological findings underscore the importance of biopsy for accurate diagnosis even of this common dermatosis.