Has anyone ever came across a patient that had pityriasis rosea but accompanied either by dizziness, balance issues, fatigue or muscle weakness. can other symptoms like these present during this type of rash?

Pityriasis rosea: Pityriasis rocea is a condition that affects skin only. If there are other symptoms present, these need to be evaluated. There are many conditions that can present with rash plus fatigue, dizziness, and muscle weakness.

Not likely: Not likely related. Many times efforts are made to make an unifying diagnosis. Sometimes 2 different conditions coexist or in your case the pityriasis is a mimicker accompanying a different condition that is causing your other symptoms.