Pityriasis rosea and pityriasis rosea-like eruptions: How to distinguish them?

To the Editor: We appreciate the article from Bitar et al1 on ibrutinib-associated pityriasis rosea (PR)-like rash that allows us to share our experience and make some observations. Recently, we proposed criteria to distinguish PR from PR-like eruptions (Table I). In fact, distinguishing them is of paramount importance, as a typical PR may develop during but independently from a therapy.2,3 During PR, a self-limiting exanthematous disease associated with the endogenous systemic reactivation of human herpes virus (HHV)-6 and/or HHV-7, the drug (if indispensable for the health of the patient and except for immunosuppressive therapies that can favor viral reactivation) may be cautiously continued.