Ria Rai; Varsha Jamale
Abstract
Background: Cutaneous verrucae (warts) are benign epithelial proliferations caused by human papillomavirus (HPV). HPV acts by upregulating epithelial cell replication and downregulating host immune responses. Hence, treatment could be aimed at the virus (via antiviral drugs like valacyclovir) or the ...
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Background: Cutaneous verrucae (warts) are benign epithelial proliferations caused by human papillomavirus (HPV). HPV acts by upregulating epithelial cell replication and downregulating host immune responses. Hence, treatment could be aimed at the virus (via antiviral drugs like valacyclovir) or the immune system (via immunomodulators like zinc sulfate). It is important to identify which pathogenesis should be preferably targeted for safe and effective therapy. We aimed to compare the efficacy and safety of oral valacyclovir versus oral zinc sulfate in the treatment of cutaneous verruca.Methods: Fifty patients clinically diagnosed with warts were randomly divided into two groups: Group A (n = 25), treated with oral valacyclovir (1000 mg/day), and Group B (n = 25), treated with oral zinc sulfate (400 mg/day). All patients were evaluated using a Visual Analogue Scale (VAS) and the Physician’s Global Assessment (PGA) and were followed up for 12 weeks. The results were analyzed using R software version 3.6.0.Results: A significant decrease in the number of warts from baseline to the fifth follow-up visit was noted in Group A (P < 0.05) but not in Group B (P > 0.05). Both the groups showed a significant improvement visit-wise (P < 0.05) with respect to both VAS and PGA scores, but Group A (25.00 ± 28.58 and 1.60 ± 1.61; P < 0.05) showed marked improvement compared to Group B (60.40 ± 8.89 and 2.96 ± 0.35; P < 0.05).Conclusion: Oral valacyclovir is more efficacious than oral zinc sulfate in the treatment of cutaneous verrucae. Both are equally safe.
Arun Achar; Pratim Chakraborty Partha; Tarapada Ghosh; Biswanath Naskar; Tapobrata Guharay; Samiran Bisai
Volume 14, Issue 2 , 2011, , Pages 52-57
Abstract
Background: Acyclovir, a specific and selective inhibitor of replication of herpesviridae family, has well documented efficacy for speedy rash healing and decreasing pain of herpes zoster. Limited oral bioavailability of acyclovir requires frequent dosing. Valacyclovir is rapidly and almost completely ...
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Background: Acyclovir, a specific and selective inhibitor of replication of herpesviridae family, has well documented efficacy for speedy rash healing and decreasing pain of herpes zoster. Limited oral bioavailability of acyclovir requires frequent dosing. Valacyclovir is rapidly and almost completely converted to acyclovir in vivo and gives three to fivefold increase in acyclovir bioavailability. The aim of this study was to assess the clinical efficacy, safety and tolerability of oral valacyclovir versus standard oral acyclovir in the treatment of herpes zoster. Methods: A blind randomized prospective study was performed during May 2007 to August 2007 in Midnapore Medical College. Immunocompetent patients, aged ≥40yrs presenting with herpes zoster within 72 hours after onset of rash were enrolled and randomized to receive one of the following treatments: 1000 mg of valacyclovir thrice daily for 7 days or acyclovir 800 mg 5 times daily for 7 days. A total of 60 patients were included and randomized to receive either valacyclovir (n=30) or acyclovir (n=30) and they were evaluated at 8 days, 15 days and 29 days, respectively. Results: A statistically significant reduction of skin lesion and zoster associated pain were noticed in valacyclovir compared to acyclovir group. However, presence of post herpetic neuralgia on the 29th day was less in acyclovir compared to valacyclovir group (70.0% vs. 83.3%, P>0.05). Only one patient on valacyclovir and two patients on acyclovir complained of nausea and mild abdominal pain. Conclusion: We conclude that for the management of herpes zoster, valacyclovir might be superior to acyclovir in respect to reduction of skin lesions and pain.
