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Research Article| Volume 22, ISSUE 1, P76-90, January 2000

Penciclovir cream for the treatment of sunlight-induced herpes simplex labialis: A randomized, double-blind, placebo-controlled trial

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      Abstract

      Objective

      The purpose of this study was to further define the therapeutic value of penciclovir cream in the treatment of sunlight-induced herpes labialis by comparing its efficacy and tolerability with those of an inactive control (purified water).

      Methods

      In this randomized, double-blind, placebo-controlled, parallel-group clinical trial, lesions were induced by exposure to sunlight. Treatment was self-initiated within 1 hour of development of the signs or symptoms of a recurrence.

      Results

      Healthy male and female patients (mean age, 38.3 years; range, 18 to 81 years) who had a history of sunlight-induced herpes labialis (mean of 6 recurrences in previous 12 months) applied either penciclovir cream (n = 266) or purified water (n = 275). Penciclovir cream significantly decreased the time to lesion healing (P < 0.0011), with a reduction in median time of up to 2 days. The efficacy of penciclovir cream was further supported by a significant reduction in maximum lesion area (P = 0.008), a faster loss of lesion-associated symptoms (P = 0.026), and significant reductions in daily assessments of pain (P ≤ 0.040), itching (P ≤ 0.032), burning (P ≤ 0.028), and tenderness (P ≤ 0.026) as moderate or severe. These effects were reinforced by the results of the daily selfassessment of lesion attributes, with significantly fewer severe/extreme assessments of lesion size (P ≤ 0.003), noticeability (P <- 0.003), amount of scab/crust (P <- 0.003), raised/ swollen area (P ≤ 0.040), soreness/tenderness (P <- 0.043), and overall severity (P .001) throughout the study period.

      Conclusions

      Penciclovir cream has demonstrated efficacy for a broad range of clinically important outcomes. Significant effects on lesion area, lesion symptoms, and other lesion attributes extend the clinical efficacy of penciclovir cream beyond lesion healing.

      Key words

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      References

        • Whitley RJ
        Herpes simplex viruses.
        in: Fields BN Knipe DM Virology. 2nd ed. Raven Press Ltd., New York1990: 1843-1887
        • Spruance SL
        Herpes simplex labialis.
        in: Sacks SL Straus SE Whitley RJ Griffiths PD Clinical Management of Herpes Viruses. IOS Press, Amsterdam1995: 8-42
        • Spruance SL
        • Rea TL
        • Thoming C
        • et al.
        Penciclovir cream for the treatment of herpes simplex labialis: A randomized, multicenter, double-blind, placebo-controlled trial.
        JAMA. 1997; 277: 1374-1379
        • Wheeler CE
        Pathogenesis of recurrent herpes simplex infections.
        J Invest Dermatol. 1975; 65: 341-346
        • Spruance SL
        The pathogenesis of herpes simplex labialis: Experimental induction of lesions with UV light.
        J Clin Microbid. 1985; 22: 366-368
        • Spruance SL
        • Freeman DJ
        • Stewart JCB
        • et al.
        The natural history of ultraviolet radiation-induced herpes simplex labialis and response to therapy with perioral and topical formulations of acyclovir.
        J Infect Dis. 1991; 163: 728-734
        • Spruance SL
        The natural history of recurrent oral-facial herpes simplex virus infection.
        in: Semin Dermatol.11. 1992: 200-206
      1. (Abstract H81)
        • Raborn GW
        • for the Penciclovir Topical Collaborative Study Group
        Penciclovir cream for recurrent herpes simplex labialis: An effective new treatment.
        in: Programs and abstracts of the 36th Annual Meeting of the Interscience Conference on Antimicrobial Agents and Chemotherapy, New Orleans, LaSeptember 15–18, 1996
        • Wolff K
        • Gschnait F
        • Honigsman H
        • et al.
        Phototesting and dosimetry for photochemotherapy.
        Br J Dermatol. 1977; 96: 1-10
        • Sayer RM
        • Desrochers DL
        • Wilson CJ
        • Marlowe E
        Skin type, minimal erythema dose (MED) and sunlight acclimatization.
        J Am Acad Dermatol. 1981; 5: 439-443
        • Remtulla A
        • Renskers KJ
        • Goodman JJ
        Measurement of natural sunlight exposure required to produce minimal erythema dose on human skin.
        J Derm Clin Eval Soc. 1992; 3: 28-29
        • Rooney JF
        • Bryson Y
        • Mannix ML
        • et al.
        Prevention of ultraviolet light-induced herpes labialis by sunscreen.
        Lancet. 1991; 388: 1419-1422
        • Cox DR
        Regression models and life tables (with discussion).
        J R Stat Soc. 1972; 34: 187-220
        • Fiddian AP
        • Yeo JM
        • Stubbings R
        • Dean D
        Successful treatment of herpes labialis with topical acyclovir.
        Br Med J. 1983; 286: 1699-1701
        • Van Vloten WA
        • Swart RNJ
        • Pot F
        Topical acyclovir therapy in patients with recurrent orofacial herpes simplex infections.
        J Antimicrob Chemother. 1983; 12: 89-93
        • Raborn GW
        • McGaw WT
        • Grace M
        Herpes labialis treatment with acyclovir 5% modified aqueous cream: A double-blind, randomized trial.
        Oral Surg Oral Med Oral Pathol. 1989; 67: 676-679
        • Shaw M
        • King M
        • Best JM
        • et al.
        Failure of acyclovir cream in treatment of recurrent herpes labialis.
        Br Med J. 1985; 291: 7-9