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Correspondence |

Chronic Acyclovir-Resistant HSV-2 Ulcer in an Immunosuppressed Patient Treated With Topical Cidofovir

Katherine G. Evans, MD; Kelly A. Morrissey, MD; Stephen C. Goldstein, MD; Carmela C. Vittorio, MD; Alain H. Rook, MD; Ellen J. Kim, MD
Arch Dermatol. 2011;147(12):1462-1463. doi:10.1001/archderm.147.12.1462.
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Correspondence: Dr Kim, Department of Dermatology, University of Pennsylvania School of Medicine, 14 Penn Tower, Rm 1477, 1 Convention Ave, Philadelphia, PA 19104 (ellen.kim@uphs.upenn.edu).

Financial Disclosure: Dr Kim has received investigator funding from TenX, GenMab, Biocryst, Gloucester, Celgene, and Centocor.

Tan HH, Goh CL.Viral infections affecting the skin in organ transplant recipients: epidemiology and current management strategies. Am J Clin Dermatol. 2006;7(1):13-29
PubMed   |  Link to Article[[XSLOpenURL/10.2165/00128071-200607010-00003]]
Fatahzadeh M, Schwartz RA.Human herpes simplex virus infections: epidemiology, pathogenesis, symptomatology, diagnosis, and management. J Am Acad Dermatol. 2007;57(5):737-766
PubMed   |  Link to Article[[XSLOpenURL/10.1016/j.jaad.2007.06.027]]
Morfin F, Thouvenot D.Herpes simplex virus resistance to antiviral drugs. J Clin Virol. 2003;26(1):29-37
PubMed   |  Link to Article[[XSLOpenURL/10.1016/S1386-6532(02)00263-9]]
Lalezari J, Schacker T, Feinberg J,  et al. A randomized, double-blind, placebo-controlled trial of cidofovir gel for the treatment of acyclovir-unresponsive mucocutaneous herpes simplex virus infection in patients with AIDS. J Infect Dis. 1997;176(4):892-898
PubMed   |  Link to Article[[XSLOpenURL/10.1086/jid.1997.176.issue-4]]
Castelo-Soccio L, Bernardin R, Stern J, Goldstein SA, Kovarik C.Successful treatment of acyclovir-resistant herpes simplex virus with intralesional cidofovir. Arch Dermatol. 2010;146(2):124-126
PubMed   |  Link to Article[[XSLOpenURL/10.1001/archdermatol.2009.363]]
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Figure 1. The patient presented with a chronic, nonhealing, painful perianal ulcer that tested positive for herpes simplex virus type 2.

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Figure 2. Posttreatment image. There is appreciable wound healing of the perianal ulcer with healthy granulation tissue after an abbreviated course of treatment with intravenous foscarnet followed by application of topical cidofovir, 2%, ointment.




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