pityriasis rosea is considered to be a benign cutaneous condition [ 14 ] . however , in the setting of pregnancy , adverse effects on the newborn may be observed .
craniosynostosis is a congenital abnormality , which can occur as an isolated finding or as part of a syndrome with other associated features .
a woman who developed pityriasis rosea during her first trimester of pregnancy and who subsequently delivered a healthy baby with craniosynostosis is described , and observations of infants born to women who are diagnosed with pityriasis rosea during their gestation are summarized .
a 28-year - old healthy woman presented at 10 weeks gestation with a skin rash .
two weeks earlier , at eight weeks gestation , she had noticed an initial skin lesion on her abdomen ( figure 1 ) .
her husband , a 29-year - old man , had presented two months earlier with similar - appearing annular lesions on his neck ( figure 2 ) .
a larger lesion had initially appeared on his left neck . within the next five days
, additional lesions appeared on the remainder of his neck and subsequently , a few lesions appeared on his distal upper extremities .
a diagnosis of inverse pityriasis rosea was established based on the clinical history and lesion morphology .
his lesions resolved over the next two weeks after treatment with triamcinolone 0.1% cream twice daily .
cutaneous examination of the patient s lesions showed multiple annular plaques with peripheral scaling on the abdomen and back ( figure 1 ) .
a diagnosis of pityriasis rosea was established based on the appearance of the lesions and history .
cetaphil cream was applied twice daily to the patient s lesions ; the lesions resolved during the next eight weeks .
she was classified as a high - risk pregnancy and was followed closely for the remainder of her gestation .
after 15 hours of labor , the baby had not descended into the pelvis ; there was no fetal distress , and a decision for c - section was made .
his apgar scores at one and five minutes were 9/9 , weight 3827.1 g , and height 50.8 cm . prior to discharge from the hospital , it was noted that the infant had a curved head .
neurosurgery consultation confirmed the diagnosis ; at 9 weeks postpartum , endoscopic repair was performed successfully with no adverse sequelae .
pityriasis rosea classically presents as annular plaques with peripheral scale , typically located between the neck and the groin , and may be seasonal in occurrence . less commonly , it can present with lesions on the neck and extremities ( inverse pityriasis rosea ) [ 1011 ] or during pregnancy .
however , associations with human herpes virus ( hsv)-6 and hsv-7 have been observed [ 1418 ] .
several studies have found that patients with pityriasis rosea have higher levels of hsv-6 and hsv-7 detected in their skin , suggesting that infection by these viruses may have a causal effect on the development of pityriasis rosea . occasionally , pityriasis rosea has been documented in siblings or in spouses ( table 1 ) [ 1921 ] . in these circumstances ,
our patient s husband developed and cleared inverse pityriasis rosea two months prior to his wife developing classic pityriasis rosea .
similar to our patient , in the majority of cases of pityriasis rosea occurring in couples , the lesions appeared in the husband prior to the wife ( table 1 ) .
the interval between onset of pityriasis rosea in the wife after occurrence in the husband ranged from seven days to one year ( median : 2 months ) .
our review of the literature , including the patient in this report , discovered 54 women who developed pityriasis rosea during their pregnancy ( table 2   and table 3 [ 6,1214,23,24 ] ) .
the onset of pityriasis rosea ranged from week 8 of gestation ( 3 patients : cases 7 and 8 in table 2 and case 14 in table 3 ) to week 32 ( 1 patient : case 7 in table 3 ) .
the median number of weeks of pregnancy at the onset of pityriasis rosea was 19 .
twenty - five women  ages 24 to 34 ( median age 29)had no prior pregnancies . however , pityriasis rosea occurred during either the second ( 20 women ) or the third pregnancy ( 6 women ) for the other women .
most of the women ( 66% , n=35 ) developed pityriasis rosea during the second trimester of gestation ( 1328 weeks ) .
nineteen percent ( 10 women ) had the onset of their dermatosis during the first trimester ( 012 weeks ) .
only 10% ( 5 women ) experienced it in the third trimester ( 2940 weeks ) .
several retrospective studies have observed adverse events affecting the newborn in women who develop pityriasis rosea during pregnancy ( table 2 ) . in these individuals ,
the adverse events predominantly included stillbirth at 11 to 28 weeks ( median 16 weeks ) , premature delivery ( < 37 weeks ) , hypotonia , weak motion , and low birth weight . less common adverse effects were hydramnios and foramen ovale .
some investigators have discovered that pityriasis rosea occurring earlier in pregnancy , such as in the first trimester , have been more often associated with a poorer prognosis , compared to women who developed the dermatosis during the second or third trimesters .
however , our review of the literature showed that the majority of women ( 16/25 , 64% ) who experienced adverse events had the onset of pityriasis rosea that occurred during the second trimester .
the onset of pityriasis rosea occurred during the first trimester in 9 women ( 36% ) and none in the third trimester .
additional studies looking at the association between hsv-6 and hsv-7 dna and the occurrence of pityriasis rosea in pregnancy have also been performed . some of the studies found reactivation of hsv-6 during pregnancy . however , a positive correlation between viral infection and clinical features of pityriasis rosea was not established .
individual case reports , including the patient in this report , have described 29 women who developed pityriasis rosea during pregnancy and have delivered healthy newborns ( table 3 ) [ 6,1214,23,24 ] .
indeed , the literature shows a ratio of 6:5 with regards to healthy newborns versus newborns with adverse events being delivered to women with gestational pityriasis rosea .
however , the number of publications regarding gestational pityriasis rosea on the outcome of the newborn may not accurately reflect the incidence of normal newborns whose mothers had gestational pityriasis rosea , since clinicians may not report these women or journals may elect not to publish the papers .
it can occur as an isolated incidental event or as part of syndrome ( table 4 ) . as an isolated incidental finding , sagittal craniosynostosis , as observed in our patient s newborn , is the most common form .
if left unrepaired , craniosynostosis may lead to a deformed skull , elevation of intracranial pressure , and cognitive impairment .
our patient s infant was evaluated shortly after delivery and had repair of the sagittal craniosynostosis at 9 weeks , with no complications and subsequent normal development .
the incidence of sagittal craniosynostosis is about 1 in 5,000 live births . to the best of our knowledge ,
isolated craniosynostosis has not been observed in newborns of women who developed pityriasis rosea during their gestation .
indeed , the occurrence in our patient s child may merely be a coincidence and not associated with her episode of pityriasis rosea during her first trimester .
however , the true incidence is not known , since gestational pityriasis rosea is not frequently reported .
some researchers noted that pityriasis rosea occurring earlier in pregnancy had a greater probability of resulting in adverse events for the fetus , including stillbirth , low gestational weight , hypotonia , and/or premature delivery .
however , there are a similar number of reports of women who developed pityriasis rosea during their gestation and delivered normal newborns .
our patient developed pityriasis rosea during her first trimester beginning at 8 weeks gestation and lasting through 18 weeks .
her son was carried to term and delivered at 40 weeks and 6 days with apgar scores , weight , and height in normal range .
whether the presence of craniosynostosis was associated with our patient s development of pityriasis rosea during her pregnancy remains to be determined .
 background : pityriasis rosea is a papulosquamous disease . it may occur during pregnancy ; in this setting , it has occasionally been associated with adverse outcomes.purpose:a woman who developed pityriasis rosea at the beginning of her eighth week of gestation is described . 
 the outcomes in newborns delivered by pregnant women who developed pityriasis rosea during gestation are summarized.method:a 28-year - old woman developed pityriasis rosea during her eighth week of pregnancy . 
 her husband had pityriasis rosea two months earlier . 
 pubmed was searched for the following terms : conjugal , craniosynostosis , newborn , pityriasis , pregnancy , rosea , sagittal , spouse . 
 the papers were reviewed and the references cited were evaluated.results:our patient delivered a healthy male infant after 41 weeks of gestation . 
 he had normal weight , height , and apgar scores . 
 isolated sagittal craniosynostosis was diagnosed and was successfully treated at nine weeks after birth without complications.conclusion:several retrospective studies have investigated the possibility of adverse outcomes in infants born to women who developed pityriasis rosea during pregnancy , such as stillbirth , low gestational weight , hypotonia , and premature delivery . however , there are also reports of healthy newborns in women who have had pityriasis rosea during gestation . 
 our patient carried the fetus one week post - term and delivered a healthy boy via c - section ; isolated sagittal craniosynostosis was later diagnosed and successfully repaired . 
 the occurrence of craniosynostosis in a woman who developed pityriasis rosea during her first trimester of pregnancy may be two coincidental events . 
Introduction
Case report
Discussion
Conclusion