HERPES SIMPLEX LESIONS OF FACE TREATED WITH ODOXURIDINE APPLIED BY SPRAY GUN: RESULTS OF A DOUBLE-BLIND CONTROLLED TRIAL

Topical treatment of cutaneous herpes simplex virus infections

Topical antiviral chemotherapy has a number of potential advantages over systemic drug delivery for the treatment of cutaneous herpes simplex virus infections, including convenience; higher target tissue drug levels and greater efficacy; and specific targeting of the drug to the site of infection, with reduced cost and reduced exposure of the remainder of the body to drug side effects. Realization of these possibilities has been slow in part because of the paucity of 'active' topical drug formulations with effective penetration-enhancing agents and a technical barrier-our failure as yet to measure drug levels in the epidermis, which could guide formulation development. Recent success with a topical treatment for herpes simplex labialis should stimulate continued laboratory and clinical research in this field.

Glycyrrhizin gel as a vehicle for idoxuridine--I. Clinical investigations

The therapeutic efficacy of a new formulation that incorporates 0.2% IDU in glycyrrhizin gel has been tested on patients who suffer from herpes of the lips and nose. The preparation was significantly more effective than a commercial 0.5% IDU ointment. It reduced the healing time and produced an almost instantaneous relief from pain. The higher efficacy of the new preparation may be ascribed to the reported anti-inflammatory and antiviral activities of glycyrrhizin together with an enhanced permeation of the IDU through the skin.

Pathogenesis of recurrent herpes simplex labialis. IV. Maturation of lesions within 8 hours after onset and implications for antiviral treatment

In order to define precisely the development of recurrent herpes simplex labialis, we studied 122 untreated or placebo-treated patients who were first seen when their lesions were less than 24 hours old. Subjects were divided into three groups with lesion ages of 0 to 8, 9 to 16, or 17 to 24 hours. Lesion pain, area, and virus titer were determined for each group at the time of the first clinic visit and again on the following day, and the change in lesion severity between visits was examined. The proportion of patients with increasing or decreasing lesion values was markedly influenced by lesion age. Among 0- to 8-hour-old lesions, area, pain, and virus titer increased in 27%, 21%, and 39% of the subjects, respectively, compared to 10%, 6%, and 0% among those lesions were 17 to 24 hours old at the first visit. A decrease in lesion area, pain, and virus titer was seen in 14%, 24%, and 12% of 0- to 8-hour-old lesions, compared with 35%, 65%, and 54% of the lesions in the 17- to 24-hour age group (p = 0.03, 0.006, and 0.0002). The majority of patients in each age group had mature lesions that remained unchanged or decreased in severity between visits. The possible benefits of antiviral chemotherapy to established lesions are limited because only a small number of untreated patients have progressive disease.

Failure of neutral-red photodynamic inactivation in recurrent herpes simplex virus infections

Because photodynamic inactivation of herpes simplex virus infections may not be free of hazard, the efficacy of photodynamic inactivation with neutral red and light was evaluated in a placebo-controlled study of 170 episodes of recurrent herpes simplex virus infection in 96 patients. The preparation of neutral red that was used was shown to photoinactivate herpes simplex virus in vitro, but had no significant effect on the rate of resolution of herpetic lesions (P greater than 0.10) or on the frequency of subsequent recurrences (P greater than 0.10), except for orolabial lesions, in which an adverse effect on the rate of subsequent recurrences was observed (P less than 0.05). In the absence of demonstrated efficacy, the routine use of neutral red and light in patients with recurrent herpes simplex virus infections should be discontinued. Furthermore, other photoactive dyes should not be used until their efficacy has been demonstrated by suitably controlled clinical trials.

Herpesvirus hominis infection in patients with myeloproliferative and lymphoproliferative disorders

Infection with Herpesvirus hominis, often associated with oral ulceration, was found to be more frequent in patients with myeloproliferative and lymphoproliferative disorders than in normal populations or patients with other diseases. This increased frequency was not associated with any deficiency of the humoral antibody response, suggesting a possible impairment of cell-mediated immunity. The otherwise untreatable oral lesions appeared to respond effectively to local irradiation.

The problem or oral ulcerations in general practice with special reference to herpetic herpetiform lesions

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