Kaposi Varicelliform Eruption Medication

Updated: Dec 13, 2017
  • Author: David T Robles, MD, PhD, FAAD; Chief Editor: William D James, MD  more...
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Medication

Medication Summary

The goals of pharmacotherapy in Kaposi varicelliform eruption (KVE) are to reduce morbidity and to prevent complications.

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Antivirals

Class Summary

Nucleoside analogs are initially phosphorylated by viral thymidine kinase to eventually form a nucleoside triphosphate. These molecules inhibit HSV DNA polymerase with 30-50 times the potency of human alpha-DNA polymerase.

Acyclovir (Zovirax)

Acyclovir is indicated in genital herpes simplex, mucocutaneous herpes simplex in immunocompromised patients, herpes zoster, recurrent herpes simplex labialis, and varicella. It is a synthetic acyclic guanosine analogue that inhibits viral DNA polymerase. Acyclovir remains the treatment of choice for KVE. Systemic and/or topical antibiotics can be used for secondary bacterial infections.

Foscarnet (Foscavir)

Foscarnet is for immunocompromised hosts with HSV infection and acyclovir-resistant HSV infection. It inhibits viral replication at the pyrophosphate-binding site on virus-specific DNA polymerases. Poor clinical response or persistent viral excretion during therapy may be due to viral resistance. Patients who can tolerate foscarnet well may benefit from initiation of maintenance treatment at 120 mg/kg/d early in treatment. Individualize dosing based on renal function status.

Trifluridine (Viroptic)

Trifluridine is approved for use in ophthalmic herpes simplex, primary keratoconjunctivitis, and recurrent epithelial keratitis due to HSV types 1 and 2. It inhibits viral replication by incorporating into viral DNA in place of thymidine. If no response occurs in 7-14 days, consider other treatments.

Valacyclovir (Valtrex)

Valacyclovir is prodrug that is rapidly converted to the active drug acyclovir. It is more expensive but has a more convenient dosing regimen than acyclovir.

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