Seminars in dermatology
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Seminars in dermatology · Jun 1996
Review Randomized Controlled Trial Clinical TrialEfficacy of famciclovir in the treatment of herpes zoster.
Although vidarabine was the first systemic antiviral drug for the treatment of acute herpes zoster, the agent now used most frequently is acyclovir, a far safer drug that became available a decade ago. However, even with widespread use of acyclovir, postherpetic neuralgia (PHN) remains a principal cause of postinfectious morbidity. Newer antiviral agents, such as famciclovir and valacyclovir, have recently been introduced for the treatment of uncomplicated herpes zoster. ⋯ Most importantly, famciclovir recipients lost PHN two times faster than those receiving placebo (P = 0.02 all patients; P = 0.004 patients > or = 50 years) resulting in a reduction in the median duration of PHN (56 days all patients; 100 days patients > or = 50 years). This reduction translated to a 3.5-month reduction in the median duration of PHN for patients 50 years or older, those at greatest risk for developing the most common complication of herpes zoster. Famciclovir 500 mg administered three times a day for 7 days is an effective and well-tolerated treatment for acute herpes zoster, and is the only oral antiviral agent proven to reduce the duration of PHN when administered during acute zoster infection.
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Seminars in dermatology · Jun 1996
ReviewVaricella-zoster virus: overview and clinical manifestations.
Varicella-zoster virus (VZV) is a human pathogen that has probably infected humans since prehistoric times. Varicella-zoster virus causes chickenpox in childhood (varicella), and establishes latency in sensory ganglia after the primary infection. Varicella-zoster virus may reemerge later in life, taking advantage of the decline in immune function that occurs with aging. ⋯ Fortunately, the acute phase is self-limiting and transient. However, chronic and often debilitating pain may persist after the lesions have healed and is referred to as postherpetic neuralgia (PHN), the most common complication of herpes zoster. Similar to acute herpes zoster, the incidence of PHN increases dramatically with age.
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Herpes zoster occurs rarely in immunocompetent children and infrequently in immunocompetent young adults. However, its incidence increases with age, particularly after age 50. Reactivation of varicella-zoster virus (VZV) is characterized by a rash and is generally accompanied by considerable pain, dysesthesias, and skin hypersensitivity. ⋯ More than 50% of zoster patients over 60 years old will develop PHN, which may persist for months and even years. Thus, established PHN is difficult to manage, often causing serious morbidity, depression, and high costs in terms of consumption of healthcare resources. Currently, early antiviral treatment with famciclovir has shown promise of reducing the duration of PHN.
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Seminars in dermatology · Jun 1996
ReviewGenital herpes simplex virus and its treatment: focus on famciclovir.
The incidence of genital herpes continues to increase worldwide. Primary first-episode genital herpes are commonly associated with severe systemic symptoms. Primary first-episode lesions are usually bilateral and may from over a period of 10 days. ⋯ Although recurrent genital herpes episodes are generally limited to localized lesions without systemic symptoms, the frequent recurrence and chronicity may have a substantial psychosocial impact on a patient's well-being. Presently, there are no available treatments capable of abating the latent virus in human beings. Current management of genital herpes focuses on treatment with antiviral agents, which are effective in reducing the course of genital herpes.