Treatments for Pityriasis Rosea

F. Drago, MD; A. Rebora, MD

Disclosures

Skin Therapy Letter. 2009;14(3) 

In This Article

Abstract and Introduction

Abstract

Pityriasis rosea is a common skin disorder in children and young adults. It is a self-limiting disease with symptoms that are typically mild and tolerable. Consequently, the best treatment remains the one followed so far by generations of dermatologists: reassuring the patient and letting the condition go away on its own. However, there are times when treatment is recommended. In this paper, we review the available treatments for this skin disease.

Introduction

Discussing the treatment of pityriasis rosea (PR) with patients can be a frustrating experience. As a self-limiting disease, the best treatment regime is to reassure the patient and let the condition resolve on its own. In our experience, pruritus, when it occurs, is always mild and tolerable. Those complaining of severe pruritus have usually been "treated" either within their family, by a pharmacist, or by an inexperienced physician. For such cases, and for those who have received corticosteroids,[1] the eruption may tend to turn into erythroderma.

A recent Cochrane collaboration paper reviewed the literature on the different types of treatment used.[2] There is inadequate evidence for the efficacy of all topical medications (i.e., emollients, antihistamines, and corticosteroids). Other agents that have not been found to be significantly active include sunlight, artificial UV therapy, systemic antihistamines and corticosteroids, antiviral agents, and intravenous glycyrrhizin. There is some evidence that oral erythromycin may shorten the course of the rash and alleviate pruritus, and a recent publication reported a 73% cure rate, although 12% of the patients experienced gastrointestinal disturbances.[3] In this paper we will discuss new and existing evidence that maintain some significance today.

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