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July 11, 1977

Photodye Herpes Therapy—Cassandra Confirmed?

JAMA. 1977;238(2):133-134. doi:10.1001/jama.1977.03280020037019

THE DERMATOLOGISTS attending the meeting of the Noah Worcester Dermatologic Society (Hollywood, Fla, March 2, 1976) reacted as though a live grenade had been tossed into their midst. They had just heard a report that provided clinical support for the speculation that photodye therapy for herpes simplex infections might be carcinogenic.1,2 Also, they were reminded that recent studies questioned the efficacy of this therapy.3-5 Neither suggestion was well received by the audience. Burdened by long suffering patients and the ever increasing incidence of recurrent herpes simplex infections, these practitioners sought any reasonable treatment. They were encouraged by early reports of photodye treatment because of its readily available components and because its apparent efficacy could be explained in terms of molecular alterations in viral DNA infective units.6,7

Photoinactivation therapy is achieved in a two-step process. Painted on the unroofed vesicles, a heterotricyclic dye such as neutral red or