The correct answer is:

The lesions will resolve with no intervention.

Educational Objective:

Characterize the presentation of pityriasis rosea.

Key Point:

A "herald patch" precedes the rash in 50% of cases.

Explanation:

Pityriasis rosea is a mild skin eruption found mostly in children and young adults. A "herald patch" precedes the rash in 50% of cases. The eruption is usually asymptomatic, other than mild itching; oral lesions may be present, but they are very rare. No treatment is necessary for this condition because it will resolve in 8 to 12 weeks on its own. The differential diagnosis should include tinea corporis, drug eruption, and secondary syphilis.

Aspects of the pityriasis rosea rash may or may not have a dermatomal appearance, but, unlike herpes, will be bilateral and painless (other than pruritus). Herpes zoster virus infection typically presents with a unilateral dermatomal distribution that is severely painful. Though the herald patch may be mistaken for tinea corporis, the lesion is unresponsive to antifungal medication.

References:

Chuh A, Zawar V, Law M, Sciallis G3. Gianotti-Crosti syndrome, pityriasis rosea, asymmetrical periflexural exanthem, unilateral mediothoracic exanthem, eruptive pseudoangiomatosis, and papular-purpuric gloves and socks syndrome: a brief review and arguments for diagnostic criteria. Infect Dis Rep. 2012;4(1):e12.

Kliegman RM, et al. Diseases of the epidermis. In: Nelson Textbook of Pediatrics. 21st ed., 2020.