Pityriasis rosea typically begins with an oval, slightly raised, scaly patch — called the herald patch — on the face, back, chest or abdomen. Before the herald patch appears, some people have headache, fatigue, fever or sore throat.  A few days to a few weeks after the herald patch appears, you may notice smaller bumps or scaly spots across your face, back, chest or abdomen that look like a pine-tree pattern. The rash can cause itching.