Objectives: To evaluate the evidence for using ‘specific’ treatments in pityriasis rosea (PR), to discuss mechanisms of their action and to recommend a strategy for using them.
Methods: MEDLINE search for specific treatments for PR, with ranking of evidence into four levels and sublevels.
Results and discussion: Six specific treatments (erythromycin, artificial ultraviolet radiation, systemic corticosteroids, dapsone, rivanol and streptomycin) were reviewed. Their possible mechanisms of action were discussed. A strategy of using specific treatments is recommended.
Conclusions: Most specific treatments for PR are not supported by adequate evidence. Mechanisms of action of these treatments are largely unknown. Most patients do not require specific treatments. Erythromycin should be reserved for patients with severe pruritus unresponsive to non-specific treatments, and systemic corticosteroids should only be used as a last resort.
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