July 1991, Vol 127, No. 7 >

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Article | July 1991

Acyclovir-Resistant Varicella Zoster Responsive to Foscarnet

Kathleen J. Smith, MC; D. Chester Kahlter, MD; Charles Davis, MC; William D. James, MC; Henry G. Skelton, MC; Peter Angritt, MC

Arch Dermatol. 1991;127(7):1069-1071. doi:10.1001/archderm.1991.01680060145032.

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To the Editor.— Acyclovir-resistant herpes simplex virus (HSV) in human immunodeficiency virus (HIV)-infected patients has been reported, often after long-term therapy with acyclovir.¹ In some cases the lesions responded to foscarnet (trisodium phosphonoformate) therapy.¹ Acyclovir-resistant varicella zoster virus (VZV) has also been reported with increasing frequency in HIV-infected patients, and is commonly associated with chronic localized verrucous skin lesions.^2,3 Although in vitro sensitivity to foscarnet has been reported, we believe that this is the first report in which chronic lesions due to acyclovir-resistant varicella zoster virus have resolved after treatment with foscarnet.

Report of a Case.— A 24-year-old white man with acquired HIV infection (Walter Reed Stage VI) presented with a history of herpes-zoster occurring in the left C7-8 dermatome in July 1989. The cutaneous lesions were typical vesicular lesions of VZV. The patient was treated with high-dose oral acyclovir (4 g/d for 10 days) with apparent

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Smith KJ, Kahlter D, Davis C, James WD, Skelton HG, Angritt P. Acyclovir-Resistant Varicella Zoster Responsive to Foscarnet. Arch Dermatol. 1991;127(7):1069-1071. doi:10.1001/archderm.1991.01680060145032.

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