The efficacy of oral acyclovir during early course of pityriasis rosea: a systematic review and meta-analysis

Background: 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. Objective: We evaluated the efficacy of acyclovir for abating PR skin lesions within a fixed period. Methods: 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. Results: 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. Conclusion: 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.