Background. 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.Objective: The purpose of this study was to verify the efficacy of oral acyclovir in the treatment of pityriasis rosea.Methods: 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.Results: On the 14th clay of treatment, 79% of treated patients fully regressed compared with 4% of the placebo group. The lesions cleared in 18.5 clays 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 clays in the patients treated later. On the 7th clay, there were significantly fewer new lesions in patients treated in the first week than in those treated later.Limitations: This trial was neither randomized nor double blind. Objectivity was achieved by counting the lesions.Conclusion: 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.

BACKGROUNDDistinguishing chronic telogen effluvium (CTE) from androgenetic alopecia (AGA) may be difficult especially when associated in the same patient.OBSERVATIONSOne hundred consecutive patients with hair loss who were clinically diagnosed as having CTE, AGA, AGA + CTE, or remitting CTE. Patients washed their hair in the sink in a standardized way. All shed hairs were counted and divided "blindly" into 5 cm or longer, intermediate length (>3 to <5 cm), and 3 cm or shorter. The latter were considered telogen vellus hairs, and patients having at least 10% of them were classified as having AGA. We assumed that patients shedding 200 hairs or more had CTE. The kappa statistic revealed, however, that the best concordance between clinical and numerical diagnosis (kappa = 0.527) was obtained by setting the cutoff shedding value at 100 hairs or more. Of the 100 patients, 18 with 10% or more of hairs that were 3 cm or shorter and who shed fewer than 100 hairs were diagnosed as having AGA; 34 with fewer than 10% of hairs that were 3 cm or shorter and who shed at least 100 hairs were diagnosed as having CTE; 34 with 10% or more of hairs that were 3 cm or shorter and who shed at least 100 hairs were diagnosed as having AGA + CTE; and 14 with fewer than 10% of hairs that were 3 cm or shorter and who shed fewer than 100 hairs were diagnosed as having CTE in remission.CONCLUSIONThis method is simple, noninvasive, and suitable for office evaluation.

Background: Androgenetic alopecia needs to be scored precisely. Objective: A possible measure is the ratio between the hair density in the parietal area and that in the occipital area which, being not affected by baldness, supposedly has a ‘normal’ density. Methods: On the vertex and just below the occipital protuberance of 109 men, two 1-cm2 areas were identified. In both areas, hairs were clipped short and photographed by a videomicroscope. Hairs were then counted within a 30-mm2-wide central square section. Results: In the occipital area, the average count was 127/cm2, without differences among the Hamilton/Norwood classes. In the parietal area, the average density significantly diminished from 138 to 47/cm2. A main difference was found between classes 1–3 vertex and classes 4–6. Conclusions: The parietal/occipital ratio decreased significantly only when baldness was clinically manifest. The parietal/occipital ratio cannot be a better measure of baldness severity than the rough Hamilton/Norwood scale. The perception of early baldness does not depend on the diminished hair density, but also on the progressive thinning of the hair shafts.