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October 1996

Treatment of Acyclovir-Resistant Perianal Herpetic Ulceration With Intramuscular Interferon Alfa

Author Affiliations

Hospital Insular, Las Palmas de Gran Canaria, Spain

Arch Dermatol. 1996;132(10):1157-1158. doi:10.1001/archderm.1996.03890340017002

REPORT OF A CASE  A 28-year-old heterosexual man was found to be seropositive for the human immunodeficiency virus (HIV) in 1990. The patient had recurrent perianal ulcerations and vesicular periungual lesions that were treated with intermittent courses of oral acyclovir. His clinical history was relevant for oral candidiasis. Medications taken included didanosine, sulfamethoxazole, trimethoprim, fluconazole, and ethambutol hydrochloride.When the patient was seen initially in November 1994, the painful perianal ulceration was persistent for the previous 2 months and unresponsive to oral acyclovir treatment. The 18-cm perianal ulcer had a vesicular border (Figure 1). The CD4 cell count was 0.08× 109/L (80/μL). Initial treatment consisted of intravenous acyclovir (10 mg/kg for 8 hours for 21 days) without result.The skin biopsy taken from the active border of the lesion showed the presence of epidermal multinucleated giant cells and intranuclear inclusions consistent with herpes simplex virus (HSV) infection, without

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