From the Research
Aciclovir retreatment is recommended for pityriasis rosea in patients with extensive, persistent lesions or systemic symptoms, as it has been shown to be effective in improving rash improvement and reducing symptoms. Pityriasis rosea is a self-limiting skin disorder that typically resolves on its own within 6-12 weeks without specific treatment. However, in some cases, symptoms can be severe and impact the patient's quality of life. According to a recent network meta-analysis 1, acyclovir was found to be the best intervention for rash improvement, with a significant reduction in symptoms compared to placebo. The study found that acyclovir resulted in a risk ratio of 2.55 (CI 1.81-3.58) for rash improvement, making it a viable treatment option for patients with severe symptoms.
While some studies have suggested that aciclovir may not be effective in all cases of pityriasis rosea, the most recent and highest quality study 1 supports its use in patients with extensive, persistent lesions or systemic symptoms. The rationale for aciclovir use stems from a hypothesis that pityriasis rosea may be associated with human herpesvirus 6 or 7 reactivation in some cases, though this connection remains controversial and unproven.
In terms of treatment approach, the following options can be considered:
- Acyclovir for patients with extensive, persistent lesions or systemic symptoms
- Topical corticosteroids and antihistamines for symptom management
- Moisturizers to help alleviate itching and dryness It is essential to note that the evidence for aciclovir use in pityriasis rosea is not universally accepted, and more research is needed to fully understand its effectiveness. However, based on the current evidence, aciclovir retreatment can be considered a viable option for patients with severe symptoms, and its use should be individualized based on patient needs and response to treatment.