Combination treatment with famciclovir and a topical corticosteroid gel versus famciclovir alone for experimental ultraviolet radiation-induced herpes simplex labialis: a pilot study.
To investigate the efficacy of corticosteroids for the treatment of herpes labialis, we compared famciclovir (Famvir, 500 mg 3x/day po [per os] for 5 days) and topical fluocinonide (0.05% Lidex Gel 3x/day for 5 days) with famciclovir and topical vehicle control for experimental ultraviolet radiation-induced herpetic recurrences. We irradiated 49 volunteers, and 29 (60%) of 48 developed signs or symptoms of a recurrence. They self-initiated treatment, and we were able to evaluate them. There was a trend in the combination group toward more aborted lesions, compared with those who received antiviral therapy alone (7 [41%] of 17 vs. 1 [8%] of 12; P=.09). Combination therapy significantly reduced the median maximum lesion size (48 vs. 162 mm(2); P=.02) and the number of patients who experienced lesion pain (10 [59%] of 17 vs. 12 [100%] of 12; P=.02). Adverse events were minimal. Corticosteroids in combination with an antiviral agent may be safe and beneficial for episodic treatment of herpes labialis. Larger studies are needed to confirm these findings.
Spruance
S L
SL
Division of Infectious Diseases, School of Medicine, University of Utah, Salt Lake City, UT 84132, USA.
McKeough
M B
MB
D015075:2-Aminopurine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D000077595:Famciclovir; D005260:Female; D005447:Fluocinonide / Q000008:administration & dosage* / Q000009:adverse effects; D006560:Herpes Labialis / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D006801:Humans; D008297:Male; D010865:Pilot Projects; D014466:Ultraviolet Rays / Q000009:adverse effects*
D000998:Antiviral Agents; D005447:Fluocinonide; D015075:2-Aminopurine; D000077595:Famciclovir