Iraji Fariba, Faghihi Gita, Siadat Amir Hossein
Department of Dermatology and Skin and Stem Cell Research Center, Isfahan School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Dermatology, Skin diseases and leishmaniasis research center, Isfahan University of Medical Sciences, Isfahan, Iran.
J Res Med Sci. 2013 Nov;18(11):976-8.
Pemphigus is a group of autoimmune blistering diseases of the skin and mucous membranes caused by the presence of antibodies against adhesion molecules on the cell surface of keratinocytes. The possible role of herpes simplex virus infection in the pathogenesis of pemphigus vulgaris (PV) has been suggested. In this study, we evaluated the impact of a course of acyclovir in improvement of the pemphigus patients and reduction of the hospitalization duration.
A total of 30 patients with definitive diagnosis of PV were recruited in study. They were randomized in two groups. One group received routine treatment and another received the routine plus 2 week course of oral acyclovir (1200 mg/day). The improvement was defined as a more than 50% change in baseline severity score of the disease. All data was registered at the checklists and after follow-up period, the statistical analyses were performed by aid of t-test and Fisher's exact test.
There was no statistically significant difference in mean severity score and improvement rates between two groups at the end of study (P > 0.05). Meanwhile, there was no statistical difference in duration of hospitalization in two groups (P > 0.05) though the severity score and hospitalization duration were apparently less in acyclovir-group than control group. Neither of the patients (in acyclovir group) showed any side effect.
We did not observe any difference between response to treatment and hospitalization period in the group that was treated with acyclovir as compared with control group. However, the partial and complete remissions were higher in patients on acyclovir therapy compared to controls. In those pemphigus patients who do not respond to sufficient immunosuppressive regimen or show a sudden relapse after reaching partial or complete clinical remission, a trial of oral acyclovir therapy may have promising result.
天疱疮是一组皮肤和黏膜的自身免疫性水疱性疾病，由针对角质形成细胞表面黏附分子的抗体所致。有人提出单纯疱疹病毒感染在寻常型天疱疮（PV）发病机制中可能发挥的作用。在本研究中，我们评估了阿昔洛韦疗程对天疱疮患者病情改善及缩短住院时间的影响。
共纳入30例确诊为PV的患者进行研究。他们被随机分为两组。一组接受常规治疗，另一组接受常规治疗加为期2周的口服阿昔洛韦（1200毫克/天）治疗。病情改善定义为疾病基线严重程度评分变化超过50%。所有数据记录在检查表中，随访期结束后，借助t检验和Fisher精确检验进行统计分析。
研究结束时，两组的平均严重程度评分和改善率无统计学显著差异（P>0.05）。同时，两组的住院时间无统计学差异（P>0.05），尽管阿昔洛韦组的严重程度评分和住院时间明显低于对照组。（阿昔洛韦组）患者均未出现任何副作用。
与对照组相比，我们未观察到接受阿昔洛韦治疗的组在治疗反应和住院时间上有任何差异。然而，与对照组相比，接受阿昔洛韦治疗的患者部分和完全缓解率更高。对于那些对足够的免疫抑制方案无反应或在达到部分或完全临床缓解后突然复发的天疱疮患者，口服阿昔洛韦治疗试验可能会有不错的结果。
