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January 1992

Acyclovir in the Prevention of Severe Aphthous Ulcers

Arch Dermatol. 1992;128(1):119-120. doi:10.1001/archderm.1992.01680110133024

To the Editor.—  Recurrent aphthous ulceration (RAU) is characterized by recurring ulcers of the nonkeratinized oral mucosa. The cause of RAU has not been determined, but preliminary data have indicated that the ulcers may be caused by reactivation of locally latent varicella zoster virus (VZV).1 As acyclovir is the most effective drug therapy against VZV, an open trial was undertaken to evaluate the preventive effect of systemic acyclovir on the recurrence of RAU in severely affected patients.

Report of Cases.—  Eight otherwise healthy patients suffering from almost constant RAU consented to participation in the study (Table). Blood screening revealed no deficiencies, and acyclovir (Zovirax) tablets (800 mg twice daily) were prescribed for 10 weeks.Six patients benefited from therapy within 2 days, with either total regression of existing ulcers or striking relief of symptoms (Table). Throughout the remainder of the study, ulcers did not develop in two patients;

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