Applicability of proposed diagnostic criteria of pityriasis rosea: Results of a prospective case-control study in India

Zawar, Vijay; Chuh, Antonio

doi:10.4103/0019-5154.119950

Cited by 17 publications

(19 citation statements)

References 30 publications

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“…6 It has been proposed that diagnostic criteria exist on a continuum with classification criteria. This is indeed the case for PR, as the diagnostic criteria 2,3 are fully compatible with our proposed clinical classification. 23 Therefore, if classification criteria are already in place for a skin disease, the possibility of rendering the diagnostic criteria fully compatible with the classification criteria should be explored.…”

Section: A Protocol To Establish Diagnostic Criteria For Other Skin Dsupporting

confidence: 78%

“…To make the best effective use of these specific but insensitive manifestations, we thus created a category of optional clinical features. 2,3 For the remaining four positive clinical features (discrete circular or oval lesions, scaling on most lesions, peripheral collarette scaling with central clearance on at least two lesions, and relatively truncal and proximal limb distribution), the first three were 100% sensitive, and were thus qualified to be essential clinical features. The sensitivity of a relatively truncal and proximal limb distribution was 83.3%.…”

Section: Highly Specific But Insensitive Clinical Featuresmentioning

confidence: 99%

“…Relatively truncal and proximal limb distribution of lesions therefore joined the herald patch and the characteristic orientation as optional clinical features. 2,3 For GCS, however, such highly characteristic and almost pathognomonic clinical features are not to be found. All the positive clinical features are shared by some of the differential diagnoses of GCS.…”

Section: Highly Specific But Insensitive Clinical Featuresmentioning

confidence: 99%

“…We have previously proposed and validated, in different ethnic groups, sets of diagnostic criteria for pityriasis rosea (PR) 2,3 ( Figures 1a and 1b) and Gianotti-Crosti Syndrome (GCS) 4,5 (Figures 2a and 2b), which are the two most common paraviral exanthems (see Tables 1 and 2, respectively).…”

Section: Introductionmentioning

confidence: 99%

“…In brief, most clinical studies, including clinical trials on these exanthems, adopted different inclusion criteria, and the results cannot be readily meta-analysed. This is The diagnostic criteria of pityriasis rosea and Gianotti-Crosti syndrome -a protocol to establish diagnostic criteria of skin diseases Paper 1 A Chuh, 2 V Zawar, 3 GF Sciallis, 1 A Lee demonstrated in our Cochrane report on the treatment of PR. 7 Of the three clinical trials we ultimately included, one 8 explicitly included all subjects with classical and atypical PR, a second 9 explicitly included only patients with typical PR while excluding all patients with PR variants, and the third 10 did not mention whether patients with atypical PR were included or not.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

The diagnostic criteria of pityriasis rosea and Gianotti-Crosti syndrome – a protocol to establish diagnostic criteria of skin diseases

Chuh¹,

Zawar²,

Sciallis³

et al. 2015

Journal of the Royal College of Physicians of Edinburgh

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We established and validated diagnostic criteria for pityriasis rosea and Gianotti-Crosti syndrome. In this paper, we compare and contrast both diagnostic criteria to formulate a protocol in establishing diagnostic criteria for other dermatological diseases. The diagnostic criteria are similar in employing clear dividing lines and conjunctions ('and/or') to assure high reliability. Both sets of criteria should be applicable for all ethnic groups. Spontaneous remission is not included, so diagnosis is not delayed while waiting for disease remission. Laboratory investigations are not enlisted, so that the criteria can be used in medical care systems in different parts of the world. The diagnostic criteria are different in that pathognomonic clinical manifestations exist for pityriasis rosea, such as the herald patch and the orientation of lesions along the lines of skin cleavages. These features, however, score low for sensitivity. These specific manifestations are not seen in Gianotti-Crosti syndrome. Such differences led to different categorisation of clinical features. Atypical variants are more common for pityriasis rosea. The diagnostic criteria for pityriasis rosea therefore do not include a list of differential diagnoses, while diagnostic criteria for Gianotti-Crosti syndrome do. Using this comparison, we constructed a protocol to establish diagnostic criteria for other skin diseases. We advocate the need to justify the establishment of diagnostic criteria, that multiple diagnostic criteria for the same disease should be avoided, that diagnostic criteria should be compatible with the disease classification if applicable, and that the scope should be well-delineated with regard to clinical variants. We outline the need for validation studies to assess the criteria-related validity, test-retest intra-clinician reliability, and inter-clinician reliability. We emphasise that the establishment of diagnostic criteria should not be a generic process. We also highlight limitations of diagnostic criteria, and emphasise that no diagnostic criteria can replace the bedside experience of clinicians. keywordS acyclovir, azithromycin, hepatitis B virus, human herpesvirus 7, paraviral exanthems, viral exanthems declaraTion of inTereSTS No conflict of interest declared

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