Vegetative chronic genital herpes with satisfactory response to imiquimod

Abstract

Vegetative chronic genital herpes is an atypical presentation of herpes simplex 2 that it is usually seen in patients coinfected with human immunodeficiency virus. Clinically, it is characterized by extensive ulcers that evolve to chronification and hypertrophic pseudotumor forms. Antiviral drugs are recommended for the treatment, and acyclovir is the most used one. Foscarnet is the treatment of choice to resistant cases, although treatment failure has been reported. We report a male patient, previously diagnosed with human immunodeficiency virus who developed vegetative chronic genital herpes resistant to acyclovir and successfully treated with imiquimod.

Successful treatment of chromoblastomycosis caused by Fonsecaea pedrosoi using imiquimod

“…Although imiquimod is able to cross the skin and reach the deep dermis, no evidences of a direct effect on microbes have been documented; imiquimod probably acts on the immune system, activating Toll‐like receptors, stimulating local cytokines and activating cells from the innate and adaptive immune systems . Particularly, patients with CBM may present T‐helper type 1 hyporesponsiveness to F. pedrosoi antigens, but in patients under imiquimod treatment, an enhancement in the inflammatory response was identified, and possibly it could lead to the clearance of the pathogen and resolution of the infection, as previously suggested .…”

“…Imiquimod is a synthetic compound with activities on different infectious diseases as well as tumor cells; additionally, this drug stimulates the immune system through the activation of Toll‐like receptor . It has been used for topical treatment of external anogenital warts, actinic keratosis and superficial basal cell carcinoma .…”

“…1 Imiquimod is a synthetic compound with activities on different infectious diseases as well as tumor cells; additionally, this drug stimulates the immune system through the activation of Toll-like receptor. [7][8][9][10] It has been used for topical treatment of external anogenital warts, actinic keratosis and superficial basal cell carcinoma. 7 Additionally, some studies suggested the effectiveness of imiquimod in the treatment of other infectious and non-infectious cutaneous diseases.…”

“…[7][8][9][10] It has been used for topical treatment of external anogenital warts, actinic keratosis and superficial basal cell carcinoma. 7 Additionally, some studies suggested the effectiveness of imiquimod in the treatment of other infectious and non-infectious cutaneous diseases. [5][6][7][8] In the present study, we addressed evidences that topical treatment of imiquimod has a beneficial effect in the management of CBM in patients presenting relapses or naive of treatment, suggesting that this drug can be an option for the treatment of CBM.…”

A case of vulvar tumoral/vegetative herpes infection in an immunocompromised patient

“…Tumoral/vegetative herpes is resistant to treatment with antivirals. Immune modulators, including imiquimod and surgical excision have been proposed as treatments [9,10]. While TVH most commonly presents in patients with HIV-AIDS, clinicians should be aware that TVH can occur in other settings of immunocompromise, including chronic immunosuppressive therapy in renal transplant patients.…”