Herpes Labialis Research Articles

Wolf's Isotopic Response: Acquired Arteriovenous Haemangioma Following Oral Herpes Simplex Virus Infection.

Cutaneous arteriovenous haemangioma (AVH) is a rare benign vascular lesion, which typically occurs on the head and neck. Its aetiology is unclear but thrombosis, trauma, infection or endocrine triggers have been proposed. We report the case of a 64-year-old female presenting with acquired AVH of the upper lip following oral herpes simplex virus infection. This is the first documented occurrence of AVH as a post-herpetic isotopic response (PHIR).

P0772 Efficacy and consumption of golimumab is similar with European and American dosing regimens in Ulcerative Colitis: Results of a prospective study

Abstract Background Golimumab is a subcutaneous TNF-alpha inhibitor approved for ulcerative colitis in European Union (EU) and United States of America (US). Interestingly, maintenance dose for patients weighing ≤80 kg is different in EU and US. In EU, golimumab maintenance dose in 50 mg every 4 weeks with an option of reactive dose escalation to 100 mg every 4 weeks in case of inappropriate response. In US, maintenance dose is 100 mg every 4 weeks for all patients, irrespective of body weight and response to induction. Here we compared efficacy, safety and drug consumption of EU and US maintenance dosing of golimumab in patients weighing ≤80 kg. Methods In this investigator initiated prospective study (ClinicalTrials.gov ID: NCT04156984) we recruited 29 patients with active ulcerative colitis. After common induction (golimumab 200 mg at baseline and 100 mg at week 2) all patients received 1 year of maintenance treatment. First 15 patients received US maintenance regimen with 100 mg golimumab monthly and next 14 patients received EU maintenance regimen with 50 mg golimumab monthly. Those in EU regimen with inadequate response to induction or loss of response during maintenance phase (rectal bleeding score (RBS) > 0 or endoscopic Mayo score (eMayo) ≥ 2) increased dose of golimumab from 50 mg to 100 mg. Co-primary endpoints were endoscopic improvement (eMayo ≤ 1) at weeks 14 and 50 and clinical remission (RBS = 0 and stool frequency score (SFS) < 2) at weeks 14, 26, 38, and 50. Statistical analysis included Chi-square and Mann-Whitney tests. Results Patient demographic data are shown in Table 1. Endoscopic improvement and clinical remission rates were similar with EU and US maintenance regimens (Figure 1). 8/14 (57%) of patients in EU regimen needed dose escalation to 100 mg due to inadequate response after a median of 8.6 weeks (interquartile range 6 to 14 weeks). Drug persistence and drug consumption was similar in both maintenance regimens (Figure 1). In the US regimen 3 potentially drug-related side effects occurred (one case each: one-dermatome herpes zoster, labial herpes, skin small vessel vasculitis), but none in the EU regimen. Conclusion In this prospective study, EU and US golimumab maintenance regimens resulted in similar endoscopic improvement and clinical remission rates during the first year of treatment with golimumab in patients with ulcerative colitis weighing ≤80 kg. Due to high dose escalation rates in EU regimen dose consumption was similar in both maintenance regimens.

P1110 Results from the UPITA-Colitis Registry on the Effectiveness and Safety of Upadacitinib in the Induction phase in Patients with Ulcerative Colitis

Abstract Background Upadacitinib, a next-generation JAK inhibitor, has shown positive results in phase 3 studies and was recently approved for moderate-to-severe ulcerative colitis. Our objective is to assess its effectiveness and safety in routine clinical practice. Methods Clinical and biochemical data were retrospectively collected from 14 hospitals in Andalusia, Spain. Clinical and analytical data up to week 16 were analyzed for patients who reached that point. Clinical remission (CR) was defined as a Partial Mayo Index ≤ 2 points, clinical-biochemical remission (CBR) as a Partial Mayo Index <3 and Calprotectin <250 μg/g, and remission without steroids (RWS) as a Partial Mayo Index <3 with no corticosteroid use since week 8. An intention-to-treat analysis was performed. Results A total of 70 patients were included, with a mean age of 37 years (range 17-69), 63.4% male. 59.2% had extensive disease, 30.8% left-sided colitis, and 10% proctitis. Of these, 82.1% were non-smokers, and 13.4% were ex-smokers. Extra-intestinal manifestations were present in 36%. The mean number of prior failed advanced treatments was 2. At the start of treatment, 33% were on 5-ASA therapy, 5% on Azathioprine, and 46% were taking corticosteroids. 67% of patients had prior Zoster virus vaccination. Induction with 45 mg for 8 weeks was administered to 57% of patients, 12 weeks to 18.5%, and 16 weeks to 4.1% (Table 1a)). Clinical and biochemical efficacy data are shown in Table 1b. At the time of the study, 6 patients had discontinued treatment before week 16, including two due to primary failure, one due to reactivation of Zoster virus, one due to pneumonia, and one for personal reasons. The following mild and transient adverse effects were reported (8.9% of total patients): 2 cases of cold sores, 2 cases of acne, and 1 case of paresthesia. Conclusion Upadacitinib proves to be an effective and useful treatment for induction of remission in refractory patients with ulcerative colitis, with an acceptable safety profile. References -Danese S, Vermeire S, Zhou W, Pangan AL, Siffledeen J, Greenbloom S, Hébuterne X, D’Haens G, Nakase H, Panés J, Higgins PDR, Juillerat P, Lindsay JO, Loftus EV Jr, Sandborn WJ, Reinisch W, Chen MH, Sanchez Gonzalez Y, Huang B, Xie W, Liu J, Weinreich MA, Panaccione R. Upadacitinib as induction and maintenance therapy for moderately to severely active ulcerative colitis: results from three phase 3, multicentre, double-blind, randomised trials. Lancet. 2022 Jun 4;399(10341):2113-2128. doi: 10.1016/S0140-6736(22)00581-5. Epub 2022 May 26. Erratum in: Lancet. 2022 Sep 24;400(10357):996 -D’Haens G, Lindsay JO, Panaccione R, Schreiber S. Ulcerative colitis: shifting sands. Drugs R D 2019; 19: 227–34.9- Boland BS, Sandborn WJ, Chang JT. Update on Janus kinase antagonists in inflammatory bowel disease. Gastroenterol Clin North Am 2014; 43: 603–17

Risk factors for the formation of gastroesophageal reflux disease and erosive lesions of the esophagus in adolescents

Background. Gastroesophageal reflux disease (GERD) is a common chronic relapsing disease of the upper digestive tract, both among adults and children and adolescents. Among the adult population, this disease is most often detected in people older than 60, while in children, a significant increase in its prevalence is no­ted with age, with a maximum in adolescents. GERD is characte­rized by a long-term course, polymorphism of clinical (esophageal and extraesophageal) manifestations, often subtle (which causes patients to seek medical help late), and can lead to the development of severe complications (erosive-ulcerative reflux esophagitis, Barrett’s esophagus, adenocarcinoma) and even sudden death in children. Therefore, it is important to identify risk factors (RF) for the development of GERD and destructive lesions of the esophagus in order to timely diagnose the disease and improve the effectiveness of its treatment. The authors provide up-to-date data on the RF for GERD in adults and children. However, in available scientific literature, there is practically no information on statistically significant combinations of RF for both GERD and destructive lesions of the esophageal mucosa in adolescents, which determined the need to conduct this study. The purpose was to find out the statistically significant RF for GERD and destructive lesions of the esophageal mucosa in adolescents and to develop the corresponding prognostic mathematical models. Materials and methods. To identify RF for GERD, a survey of 106 schoolchildren aged 15–17 and 81 adolescents suffering from GERD was conducted using a questionnaire developed by authors, pre-verified and adapted for the pediatric cohort, which included 68 questions (socio-psychological, socio-economic, socio-hygienic and biological). The diagnosis of GERD was verified according to the 2015 international NICE guidelines “Gastro-oesophageal reflux disease in children and young people: diagnosis and management”, updated 2019; the diagnosis of reflux esophagitis — according to the Los Angeles classification system. Prognostic mathematical models were created using correlation-regression, univariate and multivariate analysis, stepwise discriminant and Fisher’s discriminant analysis. Statistical processing was carried out using generally accepted methods of medical statistics. Results. The main statistically significant combinations of RF for GERD were burdened family history, pathology of the gastroduodenal zone, sliding hiatal hernia, obesity, chronic stress, smoking/alcohol consumption. For destructive lesions of the esophagus, such RF were as follows: burdened GERD family history, recurrent oral herpes, neurological disorders, obesity, sliding hiatal hernia, chronic stress. Given statistically significant RFs, corresponding prognostic mathematical models were created, and examples of their practical use were provided. Conclusions. The clarified RFs made it possible to create appropriate prognostic mathematical models that have sufficiently high sensitivity and specificity, positive and negative prognostic value and can be used in the practice of pediatricians, family doctors and pediatric gastroenterologists.

Ocular findings in erythema multiforme major

Aims/Purpose: To describe the ocular findings in two cases of erythema multiforme major (EMM).Methods: Case series of 2 patients admitted to the dermatology department for episodes of EMM following oral herpes infections.Results: The first patient is a 38‐year‐old pregnant woman with a history of recurrent EMM. Eight days after the onset of her most recent episode, she started complaining of redness in her right eye, without visual blurring or pain. Her visual acuity was 20/20 in both eyes. Slit‐lamp examination revealed signs of episcleritis in her right eye and bilateral punctate epithelial defects. She was started on lubricating eye drops. Intravenous methylprednisolone was administered to alleviate the pain from oral ulcers. Two days later, her symptoms improved with reduced ocular redness but she developed severe bilateral blepharitis. She was started on topical azithromycin and advised on eyelid hygiene, leading to progressive improvement. The second patient is an 18‐year‐old male with EMM who reported bilateral eye redness that coincided with the onset of the cutaneous eruption. His visual acuity was 20/20 in both eyes. Slit‐lamp examination showed bilateral diffuse conjunctival injection, severe blepharitis, and punctate epithelial defects. He was treated with lubricants, topical dexamethasone, and ofloxacin eye drops. Significant improvement of his symptoms was observed within two days.Conclusions: Our observations highlight the importance of thorough ophthalmic evaluation in patients with EMM to ensure prompt management and prevent potential sight‐threatening complications. The presence of unilateral episcleritis or punctate epithelial defects in this context may suggest a herpes simplex virus infection, necessitating close follow‐up, especially when topical steroids are used.

Management of a case of stromal herpetic keratitis

Aims/Purpose: To present a case study of stromal herpetic keratitis (SHK) and emphasize the importance of accurate differential diagnosis and appropriate therapeutic approaches in primary care settings.Methods: A detailed anamnesis and ocular examination were conducted, including fluorescein staining to identify dendritic corneal ulcers indicative of herpetic keratitis (HK). The patient was followed closely with a combination of antiviral and corticosteroid therapy.Results: A 20‐year‐old woman presented with 72 hours of left eye redness, pain, tearing, and vision loss. No traumatic history was reported, but a recent herpetic lesion on the upper lip was noted. Clinical examination revealed significant conjunctival hyperemia and a characteristic dendritic lesion on the cornea. Detailed examination with a slit lamp showed a central dendritic ulcer stained with fluorescein and peripheral infected cells stained with rose Bengal, alongside a focal stromal inflammation. These findings confirmed the diagnosis of SHK. Follow‐up revealed resolution of the stromal inflammation and closure of the dendritic epithelial defect.Conclusions: The case underscores the critical need for accurate diagnosis of HK subtypes, as SHK requires specific treatment with topical corticosteroids in addition to antiviral therapy. Clinical guidelines indicate that the benefits of corticosteroid use in SHK outweigh the risks, though close monitoring is essential to mitigate adverse effects such as increased intraocular pressure and cataract formation. This case highlights the importance of prompt specialist referral when primary care practitioners encounter complex ocular presentations, ensuring timely and appropriate management to prevent irreversible vision loss.References Guidelines for Ocular Herpes Management. SECOIR Monography: Update on Corneal Infections. Chapters 7 and 11.

Volatile hydrocarbon exposures and immune-related illnesses among Deepwater Horizon oil spill workers.

Despite evidence from experimental studies linking some petroleum hydrocarbons to markers of immune suppression, limited epidemiologic research exists on this topic. The aim of this cross-sectional study was to examine associations of oil spill related chemicals (benzene, toluene, ethylbenzene, xylene, and n-hexane (BTEX-H)) and total hydrocarbons (THC) with immune-related illnesses as indicators of potential immune suppression. Subjects comprised 8601 Deepwater Horizon (DWH) oil spill clean-up and response workers who participated in a home visit (1-3 years after the DWH spill) in the Gulf Long-term Follow-up (GuLF) Study. Cumulative exposures to THC and individual BTEX-H constituents during the oil spill clean-up were estimated using a job-exposure matrix linking air measurement data to detailed participant work histories. Study outcomes included post-spill occurrence and/or frequency of illnesses ascertained at the home visit, including colds, flu, cold sores, pneumonia, and shingles. Frequent cold and frequent flu were defined as ≥4 colds and ≥2 episodes of flu since the spill, respectively. We examined an aggregate outcome of frequent colds, any flu, cold sores, or pneumonia since the spill. In single pollutant models, we used multivariable log-binomial regression to estimate prevalence ratios (PR) and 95% confidence intervals (CI) for associations between quartiles of THC and BTEX-H exposures with each outcome. We used quantile g-computation to estimate the joint effect of the BTEX-H mixture. We observed positive associations of increasing quartiles of THC and BTEX-H with all outcomes except shingles, with evidence of an exposure-response for most outcomes. Strongest associations were observed for frequent flu (range of PR: 1.41-1.67). The BTEX-H mixture was associated with small to modest elevations in PRs for most outcomes. This study is the first to our knowledge to demonstrate an association between oil spill BTEX-H exposures and multiple immune-related illnesses as measures of potential immune suppression. Increasing oil spill-related volatile hydrocarbon exposures may increase the risk of multiple immune-related illnesses, especially frequent cold and frequent flu. Future research on this topic using more robust measures of immune function would advance existing evidence on this relationship.

CHRONIC RECURRENT HERPETIC STOMATITIS: STRATEGIES FOR COMPREHENSIVE PATIENT’S EXAMINATION

Introduction. This research paper highlights the diagnosis and treatment of patients with chronic recurrent herpetic stomatitis, a condition caused by herpes simplex virus type 1. This disease is marked by frequent relapses, often triggered by stress, illness, or dental procedures. The aim of this study is to assess the effectiveness of using questionnaires and modern diagnostic tests to improve the accuracy of diagnosis and treatment outcomes. Subjects and materials. A total of 40 patients aged 20 to 45 were evaluated using a questionnaire and an initial clinical assessment. Recurrences were confirmed in 67.5% of the patients, with four individuals exhibiting clinical manifestations of the disease at the time of examination. Additional laboratory tests were prescribed for those presenting symptoms of chronic recurrent herpetic stomatitis. These tests included a complete blood count, IgG testing for herpes simplex virus, vitamin D level assessment, and a biochemical blood analysis focusing on liver function. Patients were also referred to relevant specialists, including an internist, a neurologist, and an infectious disease expert. Results. Based on the laboratory results, personalized treatment plans were developed, which included Valtrex (an antiviral medication), essential phospholipids, Ibuprofen (as needed), and local diode laser therapy. This approach yielded positive results, with patients reporting reduced itching and pain, and noticeable healing beginning as early as the fourth day of treatment. The author concludes that stress is a significant factor contributing to the recurrence of herpetic stomatitis. The use of advanced diagnostic techniques, such as immunological tests with molecular markers (including polymerase chain reaction, immunofluorescence methods, and enzyme-linked immunosorbent assays), enables highly accurate detection of the virus’s activity. Furthermore, a comprehensive patient history and questionnaire can help refine treatment strategies and enhance prevention efforts through the application of the latest physiotherapeutic methods.

An overview of oral pediatric infectious diseases

Pediatric oral infectious diseases, caused by a range of viral, bacterial, and fungal pathogens, represent a significant challenge in clinical practice. These infections, often influenced by age, immune status, and hygiene practices, can lead to pain, functional impairments, and systemic complications. Common viral infections such as herpetic gingivostomatitis, varicella-zoster virus (VZV) manifestations, and hand-foot-and-mouth disease present with characteristic oral lesions, often accompanied by systemic symptoms. Bacterial infections, including dental caries, gingivitis, and odontogenic infections, are primarily linked to microbial colonization, dietary habits, and poor oral hygiene. Advanced cases, such as necrotizing periodontal diseases, can have severe implications if not managed promptly. Fungal infections, predominantly caused by Candida species, occur frequently in neonates and immunocompromised children, manifesting as oral thrush or angular cheilitis, and require targeted antifungal therapy. Prevention strategies, including the use of fluoride, dietary counseling, and regular dental check-ups, play a pivotal role in reducing the incidence of these infections. Management approaches vary based on the pathogen and clinical severity, ranging from supportive care and antifungal agents to antibiotic therapy and surgical interventions in severe cases. Collaborative care between dental practitioners and other healthcare providers is essential for effective outcomes. Infection control measures within dental settings and public health initiatives, such as vaccination and oral health education, are crucial in minimizing transmission and recurrence. Addressing pediatric oral infectious diseases requires a multifaceted approach, incorporating individualized patient care, preventive measures, and public health strategies to promote optimal oral and systemic health outcomes. Continued research and innovation are vital to improving diagnostic tools and therapeutic options for managing these infections in pediatric populations.

HLA B*15:02 and carbamazepine-induced Stevens-Johnson syndrome and toxic epidermal necrolysis: first case report from Nepal with genetic analysis

Introduction and importance: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are the severe adverse drug reactions following drugs like carbamazepine, allopurinol, and infections. Here we present A 32-year-old woman developed SJS/TEN after 7 days of carbamazepine therapy, highlighting the importance of recognizing this risk, particularly in HLA-B*1502 allele carriers. Case presentation: A 32-year-old female developed fever, vomiting, and mucocutaneous blisters 7 days after starting carbamazepine. Lesions spread from the face to the chest, abdomen, and extremities, with throat discomfort and eye discharge. History included prior dizziness episodes. Examination revealed denuded skin, positive Nikolsky’s sign, and HLA-B*1502 allele positivity. Treatment comprised ceasing carbamazepine, fluid administration, and steroids. Discussion: SJS/TEN manifest with distinct symptoms and often emerge within weeks of drug exposure. Carbamazepine, a frequent trigger, poses higher risks for HLA-B1502 allele carriers. Timely identification and intervention are essential to reduce mortality rates (10-40%). Treatment involves corticosteroids and supportive measures, with pre-carbamazepine HLA-B1502 screening advised, despite potential accessibility constraints. Conclusion: This case underscores the necessity of recognizing carbamazepine-induced SJS/TEN risk, particularly in HLA-B*1502 carriers. Despite screening challenges, early intervention involving multidisciplinary specialists is essential for favorable outcomes. Increased awareness and proactive measures are vital in preventing and managing these severe reactions.

A Review on Mouth Ulcer and their Herbal Remedies

This review explores the types Mouth ulcers, often referred to as oral or mucosal ulcers, are a common and painful condition that affects the inner lining of the mouth. These small yet troublesome sores can interfere with daily activities like eating, speaking, and swallowing, significantly impacting an individual’s quality of life. Mouth ulcers come in various forms, including aphthous ulcers, traumatic ulcers, and primary herpetic gingivostomatitis, each with distinct characteristics. They may arise due to factors such as trauma, nutritional deficiencies, infections, stress, or underlying autoimmune conditions. While conventional treatments provide symptomatic relief, there is growing interest in herbal remedies as safer and more natural alternatives. Time-tested herbal solutions such as aloe vera, turmeric, neem, honey, licorice root, and papaya have shown promising results due to their anti-inflammatory, antimicrobial, and soothing properties. These remedies not only alleviate pain but also promote faster healing and may address the root causes of ulcers. causes, symptoms, and treatment options for mouth ulcers, with a particular focus on herbal remedies. By shedding light on the potential of natural treatments, this study aims to offer alternative strategies for managing mouth ulcers effectively. Additionally, it highlights the importance of further research to validate these herbal approaches and integrate them into mainstream care.

A Case Report : Recurrent Herpes Labialis In A 12 Year Old Boy

Introduction: Herpes labialis, commonly known as cold sores, is an infection predominantly caused by herpes simplex type 1 (HSV-1). Transmission of herpes labialis occurs through direct contact with active lesions or bodily fluids, including saliva, from infected individuals. Patients with herpes labialis often report prodromal symptoms before lesions appear, such as fever, fatigue, loss of appetite, and muscle aches. Localized symptoms, including pain, burning, or itching at the site of the impending eruption, are also common. This case report discusses a recurrent herpes labialis case at Wangaya Regional General Hospital, aiming to enhance understanding of the condition's presentation, management strategies to prevent recurrence, and measures to minimize transmission. Case Report : A 12-year-old boy was diagnosed with recurrent herpes labialis caused by an infection with herpes simplex virus type 1 (HSV-1). This diagnosis was based on the patient's medical history, which indicated prodromal symptoms and polymorphic lesions, as well as dermatological examination findings that showed herpetiform vesicles with crusting. The patient’s history of similar symptoms and the lesion’s localization to the vermillion border of the lips support the diagnosis of a recurrent infection. Herpes labialis is most commonly seen in children, particularly those under 19 years of age, which corresponds with the patient’s age. The primary risk factor is direct contact with an infected individual, which aligns with the patient's history of frequently sharing food and drinks with a friend who also exhibited similar symptoms. Additionally, the patient was known to share electronic cigarettes (vapes) with schoolmates. Recurrent herpes labialis can be triggered by various factors, including weakened immunity and UV exposure, both of which were present in this case. Conclusion: The main treatment provided for this patient was oral acyclovir. The use of acyclovir aims to reduce symptoms, accelerate healing, and lower the risk of infection transmission. Acyclovir works by inhibiting viral replication through the suppression of DNA polymerase, which reduces the amount of active virus and speeds up recovery. The dosage of acyclovir given to the patient was in accordance with recommended guidelines. Supportive diagnostic tests, such as serology or Tzanck smear, are recommended to confirm the diagnosis. However, in this case, the diagnosis was already established through medical history and physical examination. Given that this is a contagious disease, the patient was educated on measures to reduce the risk of transmission.

Calcifediol and paricalcitol as adjunctive therapies for HSV-1 keratitis and corneal perforation: A case report.

Herpes simplex virus 1 establishes a latent infection in trigeminal ganglia. Reactivation causes cold sores, as well as viral keratitis. The purpose of this study was to report potential benefits of using active vitamin D receptor ligands (VDR-agonists) as adjunctive therapies for the treatment of infectious corneal perforations, and prevention of HSV recurrence. A 57-year-old female with a past history of episodic, poorly-healing, corneal erosions, recurring orolabial herpetic lesions, as well as PCR-confirmed recurrences of herpes simplex keratitis presented with a burning sensation and slight pain in the right eye. Examination indicated HSV keratitis. Topical antibiotic and oral antiviral treatments were prescribed. Despite these standard-of-care treatments, a perforated corneal ulcer ensued. Corneal perforation associated with HSV-1 keratitis recurrence, later confirmed by PCR analysis of corneal scrapings. Corneal perforation was treated with a human fibrin glue, fortified with multilayered amniotic membrane transplant, as well as a therapeutical contact lens. Following surgery, calcifediol and paricalcitol were started as oral adjunctive therapies in an attempt to boost tissue regeneration and innate-immunity within the slow-healing cornea. Anterior segment optical-coherence tomography was used to measure corneal thickness. Frequent follow-ups with various specialists allowed for comprehensive patient evaluation, and meticulous screening for any signs indicating potential HSV-1 recurrence. Following calcifediol-paricalcitol therapy corneal thickening, and re-epithelization ensued. During combined calcifediol-paricalcitol therapy, the patient has had no recurrence of herpes simplex keratitis, or orolabial herpes lesions. Corneal stabilization avoided a high-risk, full-thickness corneal transplantation, facilitating future cataract surgery, and allowing for some degree of visual recovery in this eye.

Evaluating the effectiveness of topical olive leaf extract emulgel in managing recurrent herpes labialis: a randomized controlled clinical study

Recurrent herpes labialis (RHL) is a lifelong oral health issue that affects about one-third of the world’s population, causing frequent, painful, and discomfort lesions. This randomized, triple-blinded study aimed to evaluate the effectiveness of olive leaf extract (OLE) compared to acyclovir cream (Veramid 5%) in managing vesicular stage of RHL lesions. Forty patients were randomly divided into two equal groups and were instructed to apply the prescribed medication five times a day for five consecutive days. The evaluation was carried out by measuring the pain intensity on the first day before the treatment was applied (T0), 48 h (T1), and 7 days later (T2). Additionally, the day when the pain completely healed and the day when the lesion’s crust fell off spontaneously were recorded. Statistical analysis was conducted using the Mann-Whitney test at a significance level of α = 0.05. The study results indicated that there were no significant differences in pain intensity between the two groups during the three evaluation times: T0 (P = 920), T1 (P = 0.596), and T2 (P = 1.00). Furthermore, there was no significant difference in the day when the pain was completely healed (P = 0.697). However, the OLE showed a statistically significant advantage regarding the day the lesions’ crust fell off (P = 0.040). In conclusion, OLE may be a potential alternative treatment for RHL.Trial registration: isrctn.com ID: ISRCTN87606522, 04/09/2023.

A Novel Heterozygous NFKB2 Variant in a Multiplex Family with Common Variable Immune Deficiency and Autoantibodies Against Type I IFNs.

We studied a family with three male individuals across two generations affected by common variable immune deficiency (CVID). We identified a novel missense heterozygous variant (c.2602T>A:p.Y868N) of NFKB2 in all patients and not in healthy relatives. Functional studies of the mutant allele in an overexpression system and of the patients' cells confirmed the deleteriousness of the NFKB2 variant and genotype, respectively, on the activation of the non-canonical NF-κB signaling pathway. Impaired processing of p100 into p52 underlies p100 accumulation, which results in gain-of-function (GOF) of IκBδ inhibitory activity and loss-of-function (LOF) of p52 transcriptional activity. The three patients' plasma contained autoantibodies that neutralized IFN-α2 and/or IFN-ω, accounting for the severe or recurrent viral diseases of the patients, including influenza pneumonia in one sibling, and severe COVID-19 and recurrent herpes labialis in another. Our results confirm that NFKB2 alleles that are IκBδ GOF and p52 LOF can underlie CVID and drive the production of autoantibodies neutralizing type I IFNs, thereby predisposing to severe viral diseases.

Prevalence of Plantar Warts, Genital Warts, and Herpetic Infections in Greek Competitive Swimmers.

Viral outbreaks are common in the sport community. Data regarding the prevalence of plantar warts, genital warts, herpes simplex type 1 (herpes labialis), herpes zoster, and genital herpes in competitive swimmers are lacking in the literature. The purpose of this study was to determine the prevalence of those viral infections among young competitive swimmers participating in Greek swimming clubs. Swimmers' parents and adult swimmers were asked to complete an anonymous questionnaire. In total, 1047 swimmers enrolled in this study. The measured parameters included gender, age, times of infections, and seasons when athletes may be more susceptible to infections. Practicing information such as type of swimming facility, number of training years, average hours of daily training, behaviors in swimming practice, and sunlight exposure was also recorded. All infections showed a significant difference in relation to "age" and "years of training". The gender significance was observed in herpes labialis (p = 0.016) and plantar warts (p = 0.05). The prevalence of all infections in swimmers who use outdoor facilities was higher. Certain behaviors such as walking barefoot on a pool deck and sharing swimming equipment correlate with herpes simplex and plantar warts. Virus infections can affect swimmers of all ages. In our study, plantar warts and herpes labialis are more common in swimmers. Herpes zoster and sexually transmitted viruses are rarer and affect adult swimmers. The impact of cutaneous infections on swimmers can affect performance and well-being. Effective prevention and management are essential to avoid complications. Proper hygiene, medical guidance, and treatment reduce swimmers' exposure to skin viruses.

Therapeutic effects of acyclovir and acyclovir-clobetasol nanofibers vs. cream formulation for recurrent herpes labialis

ObjectivesThis study aims to compare the therapeutic effects of acyclovir nanofiber and acyclovir-clobetasol nanofiber formulations with their non-nano formulations (cream formulation) on recurrent labial herpes.Materials and methodsEighty patients with labial herpes lesions were divided into four groups, each receiving one of the following treatments: acyclovir-clobetasol nano patch, acyclovir-clobetasol cream, acyclovir nano patch, or acyclovir cream. Pain levels and recovery times were assessed. The Wilcoxon test compared pain levels, while the log-rank test compared healing and scabbing times.ResultsAcyclovir-clobetasol nanofiber and cream, along with acyclovir nanofiber, significantly reduced symptoms compared to the acyclovir cream. The recovery and scabbing times were shorter in patients who received acyclovir-clobetasol formulations compared to those receiving acyclovir alone.ConclusionAcyclovir-clobetasol combinations accelerated recovery times compared to acyclovir alone. Additionally, nanofiber formulations demonstrated enhanced healing efficacy over cream formulations.Trial registrationThis trial was retrospectively registered by Iranian Registry of Clinical Trials (IRCT) at 14/11/2023. Trial Registration number: IRCT20230926059521N1.

Cholisal® in the complex treatment of oral mucosa and periodontium inflammatory diseases in children: A review

The problem of inflammatory diseases of the oral mucosa and periodontium in children remains relevant. The article presents the etiology, clinical presentation, and treatment methods of the most common diseases in children, such as acute herpetic stomatitis, chronic recurrent aphthous stomatitis, and chronic catarrhal gingivitis. Cholisal® dental gel with analgesic, anti-inflammatory, and antimicrobial effects is addressed as part of the complex local treatment.

Establishment of a rhesus macaque model for coxsackievirus A6 infection: Pilot study to evaluate infection initiated through the respiratory or digestive track

Coxsackievirus A6 (CVA6) is a primary pathogen associated with hand, foot, and mouth disease (HFMD) and is typified by fever, rashes or herpetic lesions at distinct locations. Although HFMD patients exhibit mild symptoms, a subset of patients may develop severe complications, such as viral encephalitis, myocarditis, pneumonia, and neurological disorders. However, in addition to rodent models, such as the CVA6-infected mouse model, no definitive nonhuman primate animal model or related research or analysis tool is available, which makes the development of suitable nonhuman primate animal models particularly crucial. In this study, 3- to 4-month-old rhesus monkeys were infected via the respiratory or digestive tract, and the pathogenic, pathological, and immunological alterations following CVA6 infection were investigated. The results revealed that the infected rhesus monkeys exhibited symptoms similar to those of patients, including signs of HFMD, blood cell changes, viremia, viral excretion, and inflammatory reactions during the acute phase (1–11 days). Pathological observations revealed inflammatory reactions in the intestinal and lymph node tissues. Notably, the acute symptoms gradually waned in the recovery phase (12–120 days), and a high level of neutralizing antibodies was sustained. Intriguingly, no significant disparity was observed between the infections initiated via the respiratory or digestive tract in terms of clinical symptoms, hemogram results or virus shedding. Overall, this study yielded a comprehensive dataset regarding the physiological, pathological, and immunological outcomes of CVA6 infection in a primate host, enhancing our comprehension of the mechanism of CVA6 infection and providing essential data for related vaccine and drug development.

The application of photodynamic therapy in recurrent genital herpes

BackgroundFrequently, recurrence of genital herpes imposes significant physical and psychological burdens on patients, and existing treatments are often ineffective in preventing recurrence. Previous studies have indicated that photodynamic therapy (PDT) showed promising outcomes in the treatment of labial herpes simplex virus (HSV) infections; however, its efficacy for genital herpes remained unclear. MethodThe study screened patients with genital herpes at Daping Hospital from July 2020 to May 2024. Patients were divided into two groups based on whether they received PDT treatment. Over a one-year follow-up period, patients' healing time and recurrence rates were compared between the two groups. The cumulative incidence of recurrence and restricted mean survival time (RMST) were used to assess outcomes. Propensity score matching (PSM) was employed to minimize bias. ResultA total of 41 patients enrolled in our study, with 8 (19.5 %) received PDT. The non-PDT group exhibited a slower skin lesion healing time, averaging at 7.2 days compared to 5.4 days in the PDT group. A significant difference was observed in the cumulative incidence of recurrence between the PDT and non-PDT groups (37.5 % versus 71.4 %) after PSM. The RMST in the PDT group was 9.94 days, compared to 5.13 days in the non-PDT group before PSM, and 4.14 after PSM. ConclusionOur study demonstrated that the PDT effectively reduced lesion recovery time and delayed recurrences of genital herpes. We recommend considering PDT as a potential treatment option for patients with recurrent genital herpes.