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唇疱疹:最新进展

Herpes Labialis: An Update.

作者信息

Leung Alexander K C, Barankin Benjamin

机构信息

Department of Pediatrics, The University of Calgary, Alberta Children's Hospital, Calgary, Alberta. Canada.

Toronto Dermatology Centre, Toronto, Ontario. Canada.

出版信息

Recent Pat Inflamm Allergy Drug Discov. 2017;11(2):107-113. doi: 10.2174/1872213X11666171003151717.

Abstract

BACKGROUND

Herpes labialis is characterized by recurrent vesicular eruptions primarily on the lips and perioral skin. The condition is contagious, can cause significant discomfort/pain, and can have an adverse effect on the quality of life.

OBJECTIVE

To update the evaluation and treatment of herpes labialis.

METHODS

A PubMed search was completed in Clinical Queries using the key term "herpes labialis". Patents were searched using the key term "herpes labialis" from www.freepatentsonline.com.

RESULTS

The diagnosis of herpes labialis is mainly clinical based on classic grouped lesions (papules, vesicles, ulcers) on the lip. Antiviral therapy shortens the duration of pain and discomfort, hastens healing, and reduces viral shedding. Thus, episodic treatment is warranted, especially if the patient desires treatment for cosmetic purposes or for relief of pain. Such treatment needs to be initiated promptly, ideally in the prodromal stage and no later than 48 hours from the onset of lesions to achieve optimal results. Chronic suppressive therapy with oral antiviral agents should be considered for patients with severe or frequent (six or more episodes per year) recurrences. Recent patents related to the management of herpes labialis are also discussed.

CONCLUSION

For episodic treatment, oral antiviral agents, such as acyclovir (Zovirax), valacyclovir (Valtrex) and famciclovir (Famvir), are superior to topical antiviral therapy. Valacyclovir and famciclovir have greater oral bioavailability and are better absorbed than acyclovir, require less frequent dosing, but are more expensive and are not approved for children. Topical antiviral agents such as 5% acyclovir cream/ointment (Zovirax) ± hydrocortisone (Xerese), 1% penciclovir (Denavir) cream, and 50 mg Buccal Adhesive Tablet (ABT-50 mg) can also be used for episodic treatment of herpes labialis. These topical agents are not effective in the prevention of recurrent herpes labialis. For chronic daily suppressive therapy, oral antivirals are the treatment of choice.

摘要

背景

唇疱疹的特征为主要在唇部和口周皮肤反复出现水疱性皮疹。该病具有传染性,可引起明显不适/疼痛,并可对生活质量产生不利影响。

目的

更新唇疱疹的评估和治疗方法。

方法

在Clinical Queries中使用关键词“唇疱疹”完成PubMed检索。在www.freepatentsonline.com上使用关键词“唇疱疹”进行专利检索。

结果

唇疱疹的诊断主要基于唇部典型的成簇损害(丘疹、水疱、溃疡)进行临床诊断。抗病毒治疗可缩短疼痛和不适的持续时间,加速愈合,并减少病毒排出。因此,进行发作期治疗是有必要的,尤其是当患者出于美容目的或缓解疼痛而希望接受治疗时。这种治疗需要及时开始,理想情况下是在前驱期,且不迟于皮损出现后48小时,以达到最佳效果。对于复发严重或频繁(每年6次或更多发作)的患者,应考虑使用口服抗病毒药物进行慢性抑制治疗。还讨论了与唇疱疹管理相关的近期专利。

结论

对于发作期治疗,口服抗病毒药物,如阿昔洛韦(无环鸟苷)、伐昔洛韦(万乃洛韦)和泛昔洛韦(泛维尔),优于局部抗病毒治疗。伐昔洛韦和泛昔洛韦的口服生物利用度更高,比阿昔洛韦吸收更好,给药频率更低,但价格更贵,且未被批准用于儿童。局部抗病毒药物,如5%阿昔洛韦乳膏/软膏(无环鸟苷)±氢化可的松(泽雷塞)、1%喷昔洛韦(得纳韦)乳膏和50毫克口腔粘贴片(ABT - 50毫克),也可用于唇疱疹的发作期治疗。这些局部药物对预防复发性唇疱疹无效。对于慢性每日抑制治疗,口服抗病毒药物是首选治疗方法。

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