We found no systematic review.
We found no placebo-controlled RCTs. The only evidence available were case series. One series involved 116 patients treated with oxytetracycline, 250 mg twice daily for 3 weeks, then once daily for a similar period.11 Five patients needed two courses and three patients required three courses of treatment. Eighty patients were seen at the end of their course of treatment, 62 patients at 1-3 months post-treatment, 9 patients at 6-12 months, and 9
patients 2-5 years later when they were being treated for another condition. Only five of the returning patients relapsed.
Another case series evaluated 73 patients (5 men, 68 women) using a combination of 1% hydrocortisone cream and oxytetracycline, 250 mg twice daily.12 Seventy-one of the patients had used fluorinated topical steroids previously, and after aggravation of the eruption upon discontinuation of the steroids, virtually all of the patients recovered on the regimen of oxytetracycline and 1% hydrocortisone cream. A 6-14 month follow up to the study using a mailed questionnaire revealed that 11 of 13 respondents had remained clear without any further treatment, one had a slight recurrence, and one had a severe recurrence.
In a separate series, 40 patients were assigned to one of three groups: Group 1-15 patients treated with topical hydrocortisone and oral oxytetracycline, 250 mg twice daily; Group 2-12 patients treated with topical desonide and oxytetracycline, 250 mg twice daily; Group 3 - 7 patients treated with desonide and 6 with hydrocortisone.13 Groups 1 and 2 were assigned randomly. Group 3 patients were selected according to the mildness of their condition and one patient was included in this group because she was pregnant. In Group 1, 14 of 15 patients improved within 6 weeks and cleared within 3 months. In Group 2, improvement within 6 weeks and clearance within 3 months occurred in 11 of 12 patients. In Group 3, 12 of 13 patients responded completely. The pregnant patient experienced no improvement initially and later dropped out. There was one dropout in each of Groups 1 and 2.
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