How to Manage Severe Pityriasis Rosea: Seeking Effective Treatments

What should I do if my pityriasis rosea is getting worse?

Hello, my husband has developed many large, red patches that resemble pityriasis rosea.
We have already spent a lot of time and money on treatments, including injections and oral medications, and have also consulted traditional Chinese medicine, but it seems to be getting worse.
I suspect this may not be pityriasis rosea.
Is there really no way to treat this condition? Isn't it true that once you have had pityriasis rosea, you won't get new lesions? Why is it spreading all over his body, with the exception of his face? I really don't know when he will heal.
What is the English name for erythromycin? Why can't I find any information about erythromycin ointment online? Could you please advise if it is really effective? We would greatly appreciate your help.

Yuping, 20~29 year old female. Ask Date: 2004/01/06

Dr. Zhong Yitun reply Dermatology

If there is sufficient rest and improper use of corticosteroids is avoided (often patients insist on using them to "get better quickly"), roseola typically stops developing new rashes about two weeks after the onset of the initial rash.
Recovery usually occurs within two weeks.
More than half of the patients recover in about 4 to 6 weeks.
Your pessimism may stem from a few exceptions, often related to being constantly busy and on the go.
This condition is caused by a viral infection, and if it is dragging on, I recommend that you consistently seek treatment at Chang Gung Memorial Hospital in Kaohsiung or at Kaohsiung Medical University Hospital.
Insufficient rest and a lack of understanding about the illness, along with hasty and misguided attempts to seek treatment by visiting various hospitals, can indeed prolong a condition that would otherwise resolve in 6 weeks.
The role of erythromycin in this condition may be difficult for you to understand, and it is not advisable to purchase it for self-treatment.
It is best to continue your treatment at Chang Gung Memorial Hospital or Kaohsiung Medical University Hospital! They will surely be able to cure your husband's illness!

Reply Date: 2004/01/06

More Info

Pityriasis rosea is a common skin condition characterized by a distinctive rash that typically begins with a single "herald" patch followed by smaller lesions. While the exact cause of pityriasis rosea remains unclear, it is believed to be associated with viral infections, particularly human herpesvirus 6 and 7. The condition is generally self-limiting, with most cases resolving within six to eight weeks, but it can sometimes persist longer, leading to frustration and concern for those affected.

In managing severe cases of pityriasis rosea, it is essential to understand that while treatments can alleviate symptoms, there is no definitive cure. The primary goal of treatment is to relieve itching and discomfort. Here are some effective management strategies:
1. Topical Treatments: Over-the-counter topical corticosteroids can help reduce inflammation and itching. For more severe cases, a physician may prescribe stronger topical steroids. Calamine lotion or menthol-based creams may also provide symptomatic relief.

2. Oral Antihistamines: These can help control itching, especially at night, allowing for better sleep. Medications such as diphenhydramine (Benadryl) or cetirizine (Zyrtec) can be beneficial.

3. Phototherapy: In cases where the rash is extensive and persistent, phototherapy (light therapy) may be recommended. This treatment involves exposing the skin to controlled amounts of natural or artificial light, which can help reduce the rash and alleviate symptoms.

4. Systemic Treatments: In rare and severe cases, systemic treatments such as oral corticosteroids or other immunosuppressive medications may be considered. However, these are typically reserved for the most challenging cases due to potential side effects.

5. Alternative Therapies: Some patients find relief through alternative therapies, such as acupuncture or herbal remedies. However, it is crucial to consult with a healthcare provider before starting any alternative treatment to ensure safety and efficacy.

Regarding your concerns about the recurrence of pityriasis rosea, it is important to note that while many individuals experience only one episode in their lifetime, some may have recurrent outbreaks. The reasons for recurrence are not well understood, but it may be related to individual immune responses or other underlying health conditions.

As for the medication you mentioned, "紅黴素" is known as erythromycin in English. It is an antibiotic that is primarily used to treat bacterial infections, and it is not typically indicated for pityriasis rosea, which is believed to be viral in nature. Therefore, using erythromycin for this condition may not yield the desired results.

If you have already tried various treatments, including injections and traditional Chinese medicine, and have not seen improvement, it may be beneficial to seek a second opinion from a dermatologist. They can provide a thorough evaluation and may suggest alternative treatment options or confirm the diagnosis.

In conclusion, while pityriasis rosea can be distressing, especially when it appears severe and persistent, it is generally a self-limiting condition. Effective management focuses on symptom relief, and with time, most individuals will see improvement. If you continue to have concerns about your husband's condition, I encourage you to consult with a healthcare professional who specializes in dermatology for personalized advice and treatment options.

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