From the Research
Pityriasis rosea management in UK primary care should focus on symptom relief, with acyclovir being the best option for patients with extensive, persistent lesions or systemic symptoms, as evidenced by a recent network meta-analysis 1.
Key Considerations
- The condition is self-limiting and typically resolves within 6-12 weeks without specific treatment.
- For mild cases, reassurance and education about the benign nature of the condition is often sufficient.
- Symptomatic relief of itching can be achieved with emollients, mild to moderate potency topical corticosteroids, and oral antihistamines.
- Severe cases with extensive rash or significant symptoms may require referral to dermatology, and UVB phototherapy can be considered in persistent cases.
Treatment Options
- Acyclovir has been shown to be effective in reducing the duration of illness and improving symptoms in patients with pityriasis rosea 1.
- Oral steroids and antihistamines can also be used to control itching and improve symptoms 1.
- Topical corticosteroids, such as hydrocortisone 1% cream or mometasone furoate 0.1% cream, can be applied to affected areas to reduce inflammation and itching.
Patient Education
- Patients should be advised to avoid hot baths, excessive heat, and irritating soaps, as these can exacerbate symptoms.
- It's essential to inform patients that pityriasis rosea begins with a "herald patch" followed by a widespread rash that typically follows skin lines on the trunk in a "Christmas tree" pattern, and that recurrence is rare.
- Monitoring pregnant women with the condition is prudent due to potential rare associations with pregnancy complications, as suggested by some evidence of a possible viral etiology 2, 3.