THERAPEUTICAL NOTES   

Giornale Italiano di Dermatologia e Venereologia 2000 June;135(3):393-7

Copyright © 2000 EDIZIONI MINERVA MEDICA

language: Italian

Cidofovir: a promising topical therapy for cutaneous DNA virus infections in patients with AIDS

Calista D., Boschini A. *, Romio S. **, Landi G.

Ospedale «M. Bufalini» - Cesena Unità Operativa di Dermatologia ** Farmacia - Azienda USL * Centro Medico «San Patrignano» - San Patrignano (Rimini)

Cidofovir is a nucleoside analogue with potent activity against a broad range of DNA virus, including adeno, herpes, irido, hepadna, papova and poxvirus. Following the successful use of cidofovir topically applied to AIDS patients with recalcitrant HPV, molluscum contagiosum and herpes simplex infection, personal experience with a cream containing cidofovir 1% is reported. Three AIDS patients (2 males and 1 female, average age 36) are presented. The first was affected with flat HPV lesions of the lips, the second with warts on the face and the third with molluscum contagiosum of both face and neck. Lesions had previously been treated with diathermy, 5-fluorouracil, superficial debridement and cryotherapy, achieving only partial success. Topical cidofovir 1% was applied twice daily for 2 weeks. All three patients experienced inflammation and a burning sensation on the sites of application. The symptoms disappeared completely after treatment, which was well tolerated, and no systemic side effects were noted. Cidofovir is a new effective option for the treatment of viral dermatitis and offers significant promise in managing opportunistic DNA viral dermatosis. Unfortunately, due to its high cost, until now such therapy is limited to patients unresponsive to previous correctly followed treatments. Reviewing international literature a number of patients were successfully treated with cidofovir gel or cream but controlled trials are needed to confirm its efficacy.