A chronic erosive form of herpes A simplex virus (HSV) infection has been reported in immunosuppressed patients.1,2 Topical idoxuridine appears to have helped several patients,2 and a reduction in the quantity of immunosuppressive agents has been of benefit.1 Some patients have exhibited protracted or recurrent courses of HSV infections.2 Vidarabine (adenine arabinoside, ara-A), an effective agent for herpetic keratitis, has been used parenterally with partial success and minimal toxicity in varicellazoster infection.3,4 It has now been authorized for use in HSV encephalitis.
Report of a Case
A 65-year-old man was referred to our clinic on July 24, 1978, with a four-month history of a progressive, pruritic, and extremely painful eruption of his face. This eventually ulcerated and coalesced to involve much of the bearded area. He noted no preceding "cold sore." Chronic lymphocytic leukemia had been diagnosed in 1974. Since mid-1976, the patient had been