The Natural History of Ultraviolet Radiation-Induced Herpes Simplex Labialis and Response to Therapy with Peroral and Topical Formulations of Acyclovir

The lips of 196 patients with a historyof sun-induced herpes labialis were exposed to experimental ultraviolet radiation (UVR) and treated with acyclovir (ACV) or placebo at different times and by different routes. Of 98 placebo recipients, 39 (40%) developed 43 lesions inside or within 10 mmof the...

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Bibliographic Details
Published in:The Journal of infectious diseases 1991-04, Vol.163 (4), p.728-734
Main Authors: Spruance, Spotswood L., Freeman, Donna J., Stewart, Jeffery C. B., McKeough, Mark B., Wenerstrom, L. Gay, Krueger, Gerald G., Piepkorn, Michael W., Stroop, William G., Rowe, Nathaniel H.
Format: Article
Language:English
Subjects:
Acyclovir - administration & dosage
Acyclovir - pharmacology
Acyclovir - therapeutic use
Administration, Oral
Administration, Topical
Adult
Aged
Antibiotics. Antiinfectious agents. Antiparasitic agents
Antiviral agents
Antivirals
Biological and medical sciences
Capsules
Cream
Double-Blind Method
Female
Herpes labialis
Herpes Labialis - drug therapy
Herpes Labialis - etiology
Herpes Labialis - prevention & control
Herpes simplex
Humans
Infections
Lesions
Major Article
Male
Medical sciences
Middle Aged
Pharmacology. Drug treatments
Placebos
Recurrence
Simplexvirus - drug effects
Ultraviolet radiation
Ultraviolet Rays - adverse effects
Viruses
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Summary:The lips of 196 patients with a historyof sun-induced herpes labialis were exposed to experimental ultraviolet radiation (UVR) and treated with acyclovir (ACV) or placebo at different times and by different routes. Of 98 placebo recipients, 39 (40%) developed 43 lesions inside or within 10 mmof the irradiated zone. The temporal distribution of lesions was bimodal, 11(26%) occurring within 48 h (immediate) and 32(72%)2–7 days after UVR exposure (delayed). Prophylactic peroral ACV begun 7 days before or 5 min after UVR prevented the development of the delayed but not the immediate lesions (P < .001). When peroral ACV was started 48 h after UVR, delayed lesions developed but were less severe (P = .01–.05). Prophylactic topical ACV begun 5 min after UVR did not reduce lesion frequency or severity. ACV therapy can be efficacious, but some rapidly developing lesions are unresponsive to treatment. This suggests that more than one process may contribute to the pathogenesis of herpes labialis.
ISSN:0022-1899
1537-6613
DOI:10.1093/infdis/163.4.728