The books describe the appearance of pytariasis rosea as multiple discrete, oval or circular *flat lesions* or plaques that are *pinkish*/reddish in color with fine flat scales and peripheral collarettes. But that is how it appears on light skin/white skin. Not on skin of color.
On skin of color however, the lesions tend to appear as hyperpigmented dark brown, reddish or violaceous papules and/or plaques. The lesions present as darker and tend to appear more raised. They may or may not scale.
In all skin color types, a herald patch will first appear on the trunk days to weeks before the rest of the lesions express then one will observe the typical Christmas tree distribution. The lesions are usually asymptomatic but might itch a bit and the disease is usually self-limiting to 6-12 weeks.
When looking for an holistic dermatologist or an MD, it is important to find one who is competent in the diagnoses of skin of color. For all of us, regardless of our training, natural or medical, the books and presentations we attend mainly use images of white/light skin types when they teach. It is up to use to research, study, attend special CE courses on the topic of skin of color and pay extra attention to our patients of color. If a practitioner is not a good fit for you, keep shopping around.
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