ABSTRACT
Abstract: Background: There is a lack of evidence to support acyclovir administration in pityriasis rosea. Objective: To determine the efficacy of acyclovir in patients with typical pityriasis rosea. Methods: A systematic review and meta-analysis of experimental studies was performed in MEDLINE, SCOPUS, EMBASE and others, from January 1990 to October 2016 on acyclovir for pityriasis rosea. Random effect model was used to find the pooled Risk Ratio. Outcomes, evaluated between weeks 1 to 8, were regression of lesions, cessation of lesions, decrease of symptoms and duration of disease. Comparisons were acyclovir vs. placebo; acyclovir vs. symptomatic treatment; acyclovir vs. antibiotic; acyclovir vs. observation and combined therapy (acyclovir plus symptomatic treatment) vs. symptomatic treatment alone. Results: Seven papers were analyzed with 324 participants, of which 159 received acyclovir and 165 were controls. Acyclovir was superior to placebo for complete regression of lesions at week 1 (Risk Ratio 5.72, CI95% 2.36-13.88). However, combined therapy was not superior to symptomatic treatment at week 4 (Risk Ratio 1.46, CI95% 0.93-2.29). Individual studies showed the superiority of acyclovir for the control of symptoms and pruritus. Study limitations: We faced differences designs of trials and inconsistency between reports. Conclusion: Symptomatic treatment is a reasonable option for pityriasis rosea, and the addition of acyclovir is justified for the control of symptoms and pruritus.
Subject(s)
Humans , Male , Female , Child , Adult , Antiviral Agents/therapeutic use , Acyclovir/therapeutic use , Pityriasis Rosea/drug therapy , Antiviral Agents/administration & dosage , Placebos , Acyclovir/administration & dosage , Follow-Up Studies , Administration, Topical , Treatment OutcomeABSTRACT
Background: Macrolides are prescribed in the treatment of pityriasis rosea despite conflicting results of the limited number of studies evaluating their role in its treatment. Aim: A randomized double-blind placebo-controlled trial was conducted to evaluate the effect of azithromycin on the clinical course of pityriasis rosea. Methods: Seventy patients of pityriasis rosea were given either azithromycin (n = 35) or placebo (n = 35) and were followed-up at 2, 4 and 6 weeks. Pruritus was assessed in both groups using the visual analogue scale (VAS) . Change in the pityriasis rosea severity score (PRSS) and in the VAS were recorded as outcome measures and were compared statistically. Results: The decrease in PRSS from baseline through 2, 4 and 6 weeks within both treatment (P < 0.001) and placebo (P < 0.001) arms was found to be statistically significant; however, this change was not significantly different in the two groups (P = 0.179). Similarly, the decrease in VAS was found to be statistically significant within both groups (P < 0.001); however, the change was comparable between the two groups (P < 0.937). Analysis by Fisher's exact test did not find a significant difference between the two groups for PRSS and VAS. Conclusion: Azithromycin is not effective in pityriasis rosea and the use of macrolides for this disease should not be encouraged in clinical practice.
Subject(s)
Azithromycin/administration & dosage , Azithromycin/therapeutic use , Double-Blind Method , Female , Humans , Male , Pityriasis Rosea/drug therapy , Placebos , Severity of Illness Index , Visual Analog ScaleABSTRACT
Pityriasis rosea is an acute, self-limiting skin disease, probably of infective origin. Doxycycline is a broad-spectrum antibiotic, and most probably has an immunomodulator and an anti-inflammatory effect. To assess the efficacy of doxycycline in the treatment of pityriasis rosea in patients evaluated between January 2001 and May 2002. This was a placebo-controlled clinical trial. One hundred and twenty patients with pityriasis rosea were included in the study; all of them were above 12 years of age. They had been divided into 2 groups, the treatment group consisted of 60 patients and received doxycycline capsule. 100 mg orally for 14 days and the placebo group consisted of 60 patients and received glucose capsules for 14 days, all the patients were followed up clinically for 4 weeks after treatment, the responses were categorized into excellent, partial and no response. Forty-six patients from the treatment group completed the study. Excellent response was achieved in 30 patients [65%], partial response in 15 patients [33.5%] and no response in 1 patient [1.5%]. Forty patients from the placebo group completed the study. Excellent response was achieved in 4 patients [10%], partial response in 20 [50%] and no response in 16 patients [40%]. The results were statistically significant. We concluded that doxycycline was effective in the treatment of pityriasis rosea, with very few adverse effects