- Ali S. Salloom, Mohammed J.E. Ahmed, Nameer K. Al-Sudany
- Babil Health Directorate, Mahawil General Hospital.
- Email: firstname.lastname@example.org.
- Al Yarmouk teaching Hospital.
- Email: email@example.com.
- Ibn Sina University for Medical and Pharmaceutical Sciences.
- Email: firstname.lastname@example.org.
Background: Pityriasis rosea is a common dermatological eruption which is self-limiting with unknown etiology. Many therapeutic agents have been suggested for its treatment but none of them has gained a uniform consensus. Objective: To assess the efficacy of erythromycin and prednisolone in reducing the duration of PR. Methods: This is a systematic open placebo-controlled study and a comparative therapeutic trial conducted through the period from September 2008 to September 2009 in the Department of Dermatology and Venereology at the Al-Yarmouk Teaching Hospital. Total 75 patients were included in this study and their demographic information and history of disease, drug and family was recorded. Skin examination was conducted with focus on the distribution and morphology of the lesions. The patients presented within two weeks of the appearance of their rash were included and were divided into three groups (25 patients in each group). In group I, adult patients were given erythromycin capsules 250 mg for 4 times per day and children were given erythromycin syrup 25mg/kg in 4 doses/day. Adult patients in group II were given prednisolone tablets 20mg in two doses daily whereas its 0.5mg a day (2 doses) were given to children. Group III was a placebo group which received glucose capsules (100mg) four times daily. The duration of treatment was two weeks and every patient was seen at presentation and asked to attend for evaluation every two weeks until complete disappearance of rash. Results: In total, 75 patients completed this study of which 44 (58.67%) were females while 31 (41.33%) were males. The mean age of all patients was 19.19±13.75 years. After two weeks of treatment, the results showed that in erythromycin group, the symptoms got cleared in 76% of patients at the end of the two weeks as compared to prednisolone group (36%; P=0.005) and placebo group (12%; P=0.0000064). Prednisolone was found better than placebo with a significant statistical difference (p-value=0.05). The rash disappeared in 88% & 100% of erythromycin-treated patients, 60% & 84% of prednisolone-treated patients and 24% & 64% in placebo group patients at the end of four and six weeks of therapy respectively. Average number of days for PR to clear in erythromycin-treated patients was 16.32±8.74 days and in prednisolone-treated patients, it was 26.8±14.69. While in placebo group, it was 38.8±14.29 (P=0.001). Timing of initiation of treatment, whether it was started within the first week or the second week, showed minor impact on the course of PR in all therapeutic groups (P=0.26, 0.87 and 0.47 for erythromycin, prednisolone and placebo group respectively). Conclusions: Both erythromycin and prednisolone are found effective in reducing the duration of PR; however, erythromycin was found superior to prednisolone.