acyclovir and Pityriasis-Rosea

Pityriasis rosea (PR) is a dermatological disease with an erythemato-papulosquamous manifestation, distributed on the trunk and extremities affecting healthy people, especially children and young people between 10 and 35 years of age. The evolution is 6 to 8 weeks and may remain for 3 to 6 months. It regresses spontaneously and can leave changes in the skin color but reversibly. Acyclovir is indicated to minimize clinical manifestations with the suspected of viral association (HHV-6 and 7). Another group of the human herpesvirus family (HHV-1 and 2), causes herpes simplex that is controlled with the antivirals, including acyclovir, as well as the amino acid L-lysine, both showing positive and similar results in reducing the number of annual manifestations and the healing time of the lesions. The aim of this study is to report a case of PR in a child, to review the literature on the etiopathogenesis of the disease and on the effects of L-lysine as well as another amino acid in the treatment. An 11-year-old girl, phototype II, presented lesions diagnosed as PR. The cycle would be 6 to 8 weeks on average. A solution of L-lysine was prescribed for 30 days, on an empty stomach. After the fourth day of therapy, the cycle of new eruptions was interrupted, initial lesions regressed, accelerating the repair of larger lesions resulting in an improvement of the clinical condition. We concluded that the administration of L-lysine, in therapeutic doses, can be a safe alternative for the PR control.

Topics: Acyclovir; Adolescent; Child; Female; Herpesvirus 6, Human; Herpesvirus 7, Human; Humans; Lysine; Pityriasis Rosea

Acyclovir has been reported as a potential therapy for pityriasis rosea (PR) in several clinical trials on the basis of evidence of the involvement of human herpes viruses 6 and 7.. We evaluated the efficacy of acyclovir for abating PR skin lesions within a fixed period.. We searched 4 databases for clinical trials that used oral acyclovir to treat PR and performed systematic review and meta-analysis to determine oral acyclovir's effect on skin lesions on the 14th day after commencing treatment.. Five clinical trials including four randomized controlled trials were identified that compared the effects of oral acyclovir (n = 133) and nonacyclovir (n = 140) in patients with PR. Oral acyclovir significantly reduced erythema (odds ratio [OR] 11.30; 95% CI = 5.70-22.41; p < .01) and limited lesion formation (OR 8.67; 95% CI = 3.29-22.81; p < .01) compared with nonacyclovir treatment on the 14th day. These results were in agreement with the results of subgroup analysis of only high-dose oral acyclovir treatment and randomized controlled trials.. Oral acyclovir may be a relatively safe and effective treatment in the early course of PR, and patients with PR may achieve faster symptoms control with acyclovir.

Topics: Acyclovir; Antiviral Agents; Female; Humans; Male; Pityriasis Rosea; Treatment Outcome

Many clinical trials have been conducted on the treatment of pityriasis rosea (PR). Our aim was to establish a position statement for the management of adults with PR based on the best available evidence. We searched PubMed for all reports on randomized controlled trials for the treatment of PR published in the past 30 years. We retrieved 14 articles reporting randomized controlled trials, and found five which met our quality requirements for in-depth analyses. Erythromycin was found in a well-conducted triple-blind study to cast significant impacts on clinical outcomes. However, adverse gastrointestinal effects were fairly common. Another well-conducted study on azithromycin reported no significant benefit. It was reported in three well-conducted studies on oral acyclovir in low dose (400 mg three times daily for 7 days or 400 mg five times daily for 7 days) and high dose (800 mg five times daily for 7 days), that acyclovir is effective in attaining rash regression and lessening the pruritus. When compared against each other, the high-dose regimen demonstrated no benefit over the low-dose regimens. Our statement comprises the follows: (i) The diagnosis of PR should be ascertained; (ii) The patients should be assessed for rash severity and impacts on quality of life; (iii) PR is a self-limiting disease, and most patients do not necessitate any treatment; (iv) For patients necessitating active treatment, oral acyclovir as 400 mg three times daily for 7 days can be considered; (v) Attention should be given to adverse effects and contraindications of acyclovir; (vi) When PR occurs in early pregnancy, oral antiviral therapy could be considered after consulting experienced clinicians; (vii) Inadequate information exists in the use of acyclovir to treatment PR in children and breastfeeding women; and (viii) Treating PR is an off-label use of acyclovir, and this has to be discussed with experienced colleagues and the patients.

Topics: Acyclovir; Humans; Pityriasis Rosea; Quality of Life

Pityriasis rosea (PR) is a papulosquamous disease with an unknown aetiology, but recently the role of two herpes viruses human herpes virus 6 and human herpes virus 7 was defined as being the aetiology of PR.. The aim of this study was to compare a low dose (400 mg five times a day for a week) anti-viral agent, acyclovir, with follow-up protocol for the treatment of PR.. A randomized, investigator-blind, prospective, 4-week study was designed. Sixty-four patients with PR presenting at the outpatient clinic were randomly allocated to acyclovir (400 mg five times a day for 1 week) or follow-up group. Fifty-four of them completed the period of study and their clinical responses such as improvement rate of erythema, and scaling and occurrence of complications were evaluated by two dermatologists using weekly photographic records.. Statistically, acyclovir was more effective than follow-up in reducing erythema at the end of the first, second, third and fourth week of treatment. Although the decrease in scaling was higher in the acyclovir group at the end of the first, second and third week of treatment, there was no statistical significance between two groups at the end of fourth week of treatment in the both groups.. According to our study, acyclovir may be more effective than follow-up in reducing erythema and shortening of duration of PR even in lower doses than was applied in previous studies. So given the safety of acyclovir, we suggest to our colleagues to consider this treatment when facing a patient suffering from this conundrum, at least in extensive or having pruritus ones.

Topics: Acyclovir; Adolescent; Adult; Antiviral Agents; Humans; Middle Aged; Pityriasis Rosea; Prospective Studies

The association of human herpesvirus 6 (HHV-6) and HHV-7 with pityriasis rosea suggests that systemic drugs directed against HHV may hasten recovery of patients with pityriasis rosea.. The purpose of this study was to verify the efficacy of oral acyclovir in the treatment of pityriasis rosea.. Eighty-seven consecutive patients were treated for 1 week with either oral acyclovir (800 mg 5 times daily) or placebo. In all patients, the time of lesion clearing and the number of new lesions appearing during treatment were recorded.. On the 14th day of treatment, 79% of treated patients fully regressed compared with 4% of the placebo group. The lesions cleared in 18.5 days in treated patients and in 37.9 days in the placebo group. Clearance was achieved in 17.2 days in patients treated in the first week from onset and in 19.7 days in the patients treated later. On the 7th day, there were significantly fewer new lesions in patients treated in the first week than in those treated later.. This trial was neither randomized nor double blind. Objectivity was achieved by counting the lesions.. Acyclovir may be effective in the treatment of pityriasis rosea, especially in patients treated in the first week from onset, when replicative viral activity of HHV is probably very high.

Topics: Acyclovir; Administration, Oral; Adult; Antibodies, Viral; Antiviral Agents; Dose-Response Relationship, Drug; Female; Herpesvirus 6, Human; Herpesvirus 7, Human; Humans; Immunoglobulin G; Male; Pityriasis Rosea; Time Factors; Treatment Outcome

Pityriasis rosea is a dermatological disease with a well-documented clinical appearance, but less is known about causes and treatment. Bell's palsy is a neurological condition leading to acute idiopathic hemifacial paralysis. Recent studies indicate that human herpesvirus (HHV) 6-7 reactivation may be a contributing factor to both conditions. We report a case of the 2 concurrent diagnoses that supports a common contributing factor and suggests further awareness and research into the role HHV 6-7 may play in the aetiology of both conditions.

Topics: Acyclovir; Antiviral Agents; Bell Palsy; Child; Female; Glucocorticoids; Herpesvirus 6, Human; Herpesvirus 7, Human; Humans; Pityriasis Rosea; Prednisone; Roseolovirus Infections

Topics: Acyclovir; Administration, Oral; Adolescent; Antiviral Agents; Humans; Male; Pityriasis Rosea; Ultraviolet Therapy

Topics: Acyclovir; Administration, Oral; Adolescent; Antiviral Agents; Humans; Male; Pityriasis Rosea; Ultraviolet Therapy

Topics: Acyclovir; Adolescent; Antiviral Agents; Diagnosis, Differential; Humans; Male; Phototherapy; Pityriasis Rosea; Thorax