Skip to main content
Log in

Viral Diseases of the Skin

Diagnosis and Antiviral Treatment

  • Therapy In Practice
  • Published:
Pediatric Drugs Aims and scope Submit manuscript

Abstract

Viral diseases in children can present with characteristic mucocutaneous manifestations. This article focuses, from a practical clinical point of view, on the laboratory and clinical diagnoses, and treatment of pediatric dermatological diseases that have specific antiviral therapies: herpes virus infections (including varicella), papillomavirus infections and molluscum contagiosum.

Special issues, such as viral infections in pregnancy, therapy of viral infections in immunosuppressed children, as well as special problems associated with the epidemiology of genital herpes and papillomavirus infections in adolescents are discussed.

The antivirals discussed in detail include: aciclovir, valaciclovir, famciclovir, penciclovir, cidofovir, foscar-net and the immune response modulator, imiquimod. Since these antiviral drugs generally have not been evaluated in children, caution should be exercised with their usage.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Table I
Fig. 1
Table II
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Recommended childhood immunization schedule, United States, January-December. Committee on Infectious Diseases. Pediatrics 2001; 107: 202–4

    Article  Google Scholar 

  2. Raimer SS, Raimer BG. Family violence, child abuse, and anogenital warts. Arch Dermatol 1992; 128: 842–4

    Article  PubMed  CAS  Google Scholar 

  3. Ashley RL, Wald A. Genital herpes: review of the epidemic and potential use of type-specific serology. Clin Microbiol Rev 1999; 12: 1–8

    PubMed  CAS  Google Scholar 

  4. Snoeck R, Andrei G, De Clercq E. Current pharmacological approaches to the therapy of varicella zoster virus infections: a guide to treatment. Drugs 1999; 57: 187–206

    Article  PubMed  CAS  Google Scholar 

  5. Simonart T, Noel JC, De Dobbeleer G, et al. Treatment of classical Kaposi’s sarcoma with intralesional injections of cidofovir: report of a case. J Med Virol 1998; 55: 215–8

    Article  PubMed  CAS  Google Scholar 

  6. Meadows KP, Tyring SK, Pavia AT, et al. Resolution of recalcitrant molluscum contagiosum virus lesions in human immunodeficiency virus-infected patients treated with cidofovir. Arch Dermatol 1997; 133: 987–90

    Article  PubMed  CAS  Google Scholar 

  7. Tyring S. Immune response modification: imiquimod. Australas J Dermatol 1998; 39Suppl. 1: S11–3

    PubMed  Google Scholar 

  8. Trizna Z, Tyring SK. Antiviral treatment of diseases in pediatric dermatology. Dermatol Clin 1998; 16: 539–52

    PubMed  CAS  Google Scholar 

  9. Kesson AM. Use of acyclovir in herpes simplex virus infections. J Paediar Child Health 1998; 34: 9–13

    Article  CAS  Google Scholar 

  10. Amir J, Harel L, Smetana Z, et al. Treatment of herpes simplex gingivostomatitis with acyclovir in children: a randomised double blind placebo controlled study. BMJ 1997; 314: 1800–3

    Article  PubMed  CAS  Google Scholar 

  11. Schwartz GS, Holland EJ. Oral acyclovir for the management of herpes simplex virus keratitis in children. Ophthalmology 2000; 107: 278–82

    Article  PubMed  CAS  Google Scholar 

  12. Gutierrez KM, Falkovitz Halpern MS, Maldonado Y, et al. The epidemiology of neonatal herpes simplex virus infections in California from 1985 to 1995. J Infect Dis 1999; 180: 199–202

    Article  PubMed  CAS  Google Scholar 

  13. Weston WL, Morelli JG. Herpes simplex virus-associated erythema multiforme in prepubertal children. Arch Pediatr Adolesc Med 1997; 151: 1014–6

    Article  PubMed  CAS  Google Scholar 

  14. Theriault A, Cohen PR. Herpetic geometric glossitis in a pediatric patient with acute myelogenous leukemia. Am J Clin Oncol 1997; 20: 567–8

    Article  PubMed  CAS  Google Scholar 

  15. McGill SN, Cartotto RC. Herpes simplex virus infection in a paediatric burn patient: case report and review. Burns 2000; 26: 194–9

    Article  PubMed  CAS  Google Scholar 

  16. Jang KA, Kim SH, Choi JH, et al. Viral folliculitis on the face. Br J Dermatol 2000; 142: 555–9

    Article  PubMed  CAS  Google Scholar 

  17. Gutman LT, Herman-Giddens ME, Phelps WC. Transmission of human genital papillomavirus disease: comparison of data from adults and children. Pediatrics 1993; 91: 31–8

    PubMed  CAS  Google Scholar 

  18. Raguin G, Malkin JE. Genital herpes: epidemiology and pathophysiology. Update and new perspectives. Ann Med Intern Fenn 1997; 148: 530–3

    CAS  Google Scholar 

  19. Umene K, Kawana T. Molecular epidemiology of herpes simplex virus type 1 genital infection in association with clinical manifestations. Arch Virol 2000; 145: 505–22

    Article  PubMed  CAS  Google Scholar 

  20. Mertz GJ. Epidemiology of genital herpes infections. Infect Dis Clin North Am 1993; 7: 825–39

    PubMed  CAS  Google Scholar 

  21. Stanberry L, Cunningham A, Mertz G, et al. New developments in the epidemiology, natural history and management of genital herpes. Antiviral Res 1999; 42: 1–14

    Article  PubMed  CAS  Google Scholar 

  22. Kimura H, Kido S, Ozaki T, et al. Comparison of quantitations of viral load in varicella and zoster. J Clin Microbiol 2000; 38: 2447–9

    PubMed  CAS  Google Scholar 

  23. Tarlow MJ, Walters S. Chickenpox in childhood: a review prepared for the UK Advisory Group on Chickenpox on behalf of the British Society for the Study of Infection. J Infect 1998; 36Suppl. 1: S39–47

    Article  Google Scholar 

  24. Ogilvie MM. Antiviral prophylaxis and treatment in chickenpox: a review prepared for the UK Advisory Group on Chickenpox on behalf of the British Society for the Study of Infection. J Infect 1998; 36Suppl. 1: 31–8

    Article  PubMed  Google Scholar 

  25. Chiodo F, Manfredi R, Antonelli P, et al. Varicella in immunocompetent children in the first two years of life: role of treatment with oral acyclovir. Italian Acyclovir-Chickenpox Study Group. J Chemother 1995; 7: 62–6

    PubMed  CAS  Google Scholar 

  26. Kesson AM, Grimwood K, Burgess MA, et al. Acyclovir for the prevention and treatment of varicella zoster in children, adolescents and pregnancy. J Paediatr Child Health 1996; 32: 211–7

    Article  PubMed  CAS  Google Scholar 

  27. Suga S, Yoshikawa T, Yazaki T, et al. Dose-dependent effects of oral acyclovir in the incubation period of varicella. Acta Paediatr 1996; 85: 1418–21

    Article  PubMed  CAS  Google Scholar 

  28. Manfredi R, Chiodo F. Potential benefit of acyclovir for chickenpox acquired from household contacts. The Italian Acyclovir-Chickenpox Study Group. J Chemother 1997; 9: 199–202

    PubMed  CAS  Google Scholar 

  29. Lin TY, Huang YC, Ning HC, et al. Oral acyclovir prophylaxis of varicella after intimate contact. Pediatr Infect Dis J 1997; 16: 1162–5

    Article  PubMed  CAS  Google Scholar 

  30. Kumagai T, Kamada M, Igarashi C, et al. Varicella-zoster virus-specific cellular immunity in subjects given acyclovir after household chickenpox exposure. J Infect Dis 1999; 180: 834–7

    Article  PubMed  CAS  Google Scholar 

  31. Carcao MD, Lau RC, Gupta A, et al. Sequential use of intravenous and oral acyclovir in the therapy of varicella in immunocompromised children. Pediatr Infect Dis J 1998; 17: 626–31

    Article  PubMed  CAS  Google Scholar 

  32. Goldstein SL, Somers MJ, Lande MB, et al. Acyclovir prophylaxis of varicella in children with renal disease receiving steroids. Pediatr Nephrol 2000; 14(4): 305–8

    Article  PubMed  CAS  Google Scholar 

  33. Rothwell WS, Gloor JM, Morgenstern BZ, et al. Disseminated varicella infection in pediatric renal transplant recipients treated with mycophenolate mofetil. Transplantation 1999; 68: 158–61

    Article  PubMed  CAS  Google Scholar 

  34. Leung TF, Chik KW, Li CK, et al. Incidence, risk factors and outcome of varicellazoster virus infection in children after haematopoietic stem cell transplantation. Bone Marrow Transplant 2000; 25: 167–72

    Article  PubMed  CAS  Google Scholar 

  35. Chapman SJ. Varicella in pregnancy. Semin Perinatol 1998; 22(4): 339–46

    Article  PubMed  CAS  Google Scholar 

  36. Kakourou T, Theodoridou M, Mostrou G, et al. Herpes zoster in children. J Am Acad Dermatol 1998; 39 (2 Pt 1): 207–10

    Article  PubMed  CAS  Google Scholar 

  37. Petursson G, Helgason S, Gudmundsson S, et al. Herpes zoster in children and adolescents. Pediatr Infect Dis J 1998; 17: 905–8

    Article  PubMed  CAS  Google Scholar 

  38. Kimitsuki T, Komiyama S. Ramsay-Hunt syndrome in a 4-year-old child. Eur Arch Otorhinolaryngol 1999; 256Suppl. 1: S6–7

    Article  PubMed  Google Scholar 

  39. Laskaris G, Laskaris M, Theodoridou M. Oral hairy leukoplakia in a child with AIDS. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1995; 79: 570–1

    Article  PubMed  CAS  Google Scholar 

  40. Ginevri F, Losurdo G, Fontana I, et al. Acyclovir plus CMV immunoglobulin prophylaxis and early therapy with ganciclovir are effective and safe in CMV high-risk renal transplant pediatric recipients. Transpl Int 1998; 11Suppl. 1: S130–4

    PubMed  Google Scholar 

  41. Tyring SK. Human papillomavirus infections: epidemiology, pathogenesis, and host immune response. J Am Acad Dermatol 2000; 43 (1 Pt 2): S18–26

    Article  PubMed  CAS  Google Scholar 

  42. Kilkenny M, Marks R. The descriptive epidemiology of warts in the community. Australas J Dermatol 1996; 37: 80–6

    Article  PubMed  CAS  Google Scholar 

  43. Lutzner MA, Blanchet-Bardon C, Orth G. Clinical observations, virologic studies, and treatment trials in patients with epidermodysplasia verruciformis, a disease induced by specific human papillomaviruses. J Invest Dermatol 1984; 83: 18–25

    Article  Google Scholar 

  44. Kenney JW, Reuss H. Human papillomavirus as expressed in cervical neoplasia: evolving diagnostic and treatment modalities. Health Care Women Int 1994; 15: 287–96

    Article  PubMed  CAS  Google Scholar 

  45. Koutsky L. Epidemiology of genital human papillomavirus infection. Am J Med 1997; 102: 3–8

    Article  PubMed  CAS  Google Scholar 

  46. Franco EL. Epidemiology of anogenital warts and cancer. Obstetr Gynecol Clin North Am 1996; 23: 597–623

    CAS  Google Scholar 

  47. Gutman LT, St Claire KK, Everett VD, et al. Cervical-vaginal and intra-anal human papillomavirus infection of young girls with external genital warts. J Infect Dis 1994; 170: 339–44

    Article  PubMed  CAS  Google Scholar 

  48. Pransky SM, Magit AE, Kearns DB, et al. Intralesional cidofovir for recurrent respiratory papillomatosis in children. Arch Otolaryngol Head Neck Surg 1999; 125: 1143–8

    PubMed  CAS  Google Scholar 

  49. Zabawski Jr EJ, Sands B, Goetz D, et al. Treatment of verruca vulgaris with topical cidofovir [letter]. JAMA 1997; 278: 1236

    Article  PubMed  Google Scholar 

  50. Syed TA, Goswami J, Ahmadpour OA, et al. Treatment of molluscum contagiosum in males with an analog of imiquimod 1% in cream: a placebo-controlled, double-blind study. J Dermatol 1998; 25: 309–13

    PubMed  CAS  Google Scholar 

  51. Zabawski Jr EJ, Cockerell CJ. Topical cidofovir for molluscum contagiosum in children. Pediatr Dermatol 1999; 16: 414–5

    PubMed  Google Scholar 

  52. Toro JR, Wood LV, Patel NK, et al. Topical cidofovir: a novel treatment for recalcitrant molluscum contagiosum in children infected with human immunodeficiency virus 1. Arch Dermatol 2000; 136: 983–5

    Article  PubMed  CAS  Google Scholar 

  53. Feuerstein B, Jurgens M, Schnetz E, et al. Cowpox and catpox infections: 2 clinicalcase reports. Hautarzt 2000; 51: 852–6

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

The authors would like to thank the Department of Dermatology, Texas Tech University, Lubbock, Texas, USA, for the use of slides in preparing the illustrations.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Zoltan Trizna.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Trizna, Z. Viral Diseases of the Skin. Pediatr-Drugs 4, 9–19 (2002). https://doi.org/10.2165/00128072-200204010-00002

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00128072-200204010-00002

Keywords

Navigation