- Email: [email protected]
A call for twin pairs with psoriasis
758
Journal of the American Academy of Dermatology
Correspondence
agree. Yet he does not seem concerned about applying topical acyclovir ointment with a concentration of 50,000 /~g/ml six times per day for variable periods, year after year, for the attempted treatment of recurrent herpes simplex. The systemic lifetime carcinogenicity studies which have been done 11 are of little value in determining the possible local oncogenic effects of very high concentration topical application. To our knowledge no animal studies have been done to determine the possible oncogenic effect of high-concentration chronic topical acyclovir therapy on epithelial tissue. We conclude as we began: acyclovir is a great advance in antiviral therapy. Its use in the appropriate clinical setting has been efficacious and at times lifesaving. For these reasons we continue to urge our colleagues to strictly limit the use o f topical acyclovir ointment, thus avoiding waste of this valuabte drug in applications of little benefit, great cost, and uncertain tSsk.
Benjamin Raab, M.D. Allan L. Lorincz, M.D. University of Chicago Pritzker School of Medicine Chicago, IL 60637
ificity of herpes simplex virus thymidine kinase confers acyclovir-resistance. Nature 289:81-83, 1981. 11. Comprehensive summary of pre-clinical studies. Mutagenicity studies in comprehensive information for investigators--Zovirax. Research Triangle Park, NC, October, 1980, Burroughs Wellcome Co., pp. 57-59.
A call f o r t w i n p a i r s w i t h psoriasis
To the Editor: In 1971, we applied the twin method to the study of the genetics of psoriasis. 1 Twelve years later, we are conducting a follow-up survey on the original twin participants. We would like to expand our basic twin population and are asking dermatologists to send us the names of patients who are monozygotic or dizygotic twins with psoriasis and who would be willing to complete a brief, confidential questionnaire. We would appreciate the cooperation of dermatologists and that of their twin patients in this effort.
Eugene M. Farber, M.D. Professor and Chairman Department of Dermatology Stanford University School of Medicine Stanford, CA 94305
REFERENCES
1. Raab B, Lorincz AL: Genital herpes simplex--concepts and treatment. ~ AM ACAD DERMATOL5: 249-263, 1981. 2. Thiers B: Unusual treatments for herpesvims infections. I. Herpes simplex. J AM ACAD DERMATOL 7:811-816, 1982. 3. Luby J: Therapy in genital herpes. N Engl J Med 306:1356-1357, 1982. (Editorial.) 4. Package insert: Prescribing instructions--Zovirax (acyclovir) ointment 5%. Research Triangle Park, NC, October, 1982, Burroughs Wellcome Co. 5. Sibrack CD, Gutman LT, Wilfert CM, et al: Pathogenicity of acyclovir-resistant herpes simplex virus type 1 from an immunodeficient child. J Infect Dis 146:673681, 1982. 6. Sibrack CD, McLaren C, Barry DW: Disease and latency characteristics of clinical herpes simplex virus isolates after acyclovir therapy. Am J Med 73(suppl A):372-375, 1982. 7. Schipper CE, Crumpacker CS: Resistance of herpes simplex virus to acycloguanosine: The role of viral thymidine kinase and DNA polymerase loci. Proc Natl Acad Sci USA 77:2270-2273, 1980. 8. Field HJ: Development of clinical resistance to acyclovir infected mice receiving oral therapy. Antimicrob Agents Chemother 21:744-752, 1982. 9. Field HJ, Darby G: Pathogenicity in mice of strains of herpes simplex virus which are resistant to acyclovir in vitro and in vivo. Antimicrob Agents Chemother 17:209-216, 1980. 10. Darby G, Field HJ, Salisbury SA: Altered substrate spec-
REFERENCE 1. Father EM, Nall ML, Watson W: The natural history of psoriasis in 61 twin pairs. Arch Dermatol 109:209-211, 1974.
Boric a c i d - f r e e p r o d u c t s
To the Editor: Since the publication of our report, "Boric Acid Poisoning" (J AM ACAD DERMATOL7:667-673, 1982), it has been brought to our attention that several products listed in Table I have been reformulated and no longer contain boric acid. In particular, the two mouthwashes, Listerine and Chloraseptic, have eliminated boric acid as an ingredient. Massengill powder has also been changed and no longer contains this ingredient. The other products on the list still contain boric acid, although for the most part in trace quantities as a preservative. It was not our intent to suggest that these boric acid-containing products are dangerous when used as directed, but merely that potential danger exists should these products be used in excessive amounts for indications other than those listed on the respective packaging.
Journal of the American Academy of Dermatology
Correspondence
agree. Yet he does not seem concerned about applying topical acyclovir ointment with a concentration of 50,000 /~g/ml six times per day for variable periods, year after year, for the attempted treatment of recurrent herpes simplex. The systemic lifetime carcinogenicity studies which have been done 11 are of little value in determining the possible local oncogenic effects of very high concentration topical application. To our knowledge no animal studies have been done to determine the possible oncogenic effect of high-concentration chronic topical acyclovir therapy on epithelial tissue. We conclude as we began: acyclovir is a great advance in antiviral therapy. Its use in the appropriate clinical setting has been efficacious and at times lifesaving. For these reasons we continue to urge our colleagues to strictly limit the use o f topical acyclovir ointment, thus avoiding waste of this valuabte drug in applications of little benefit, great cost, and uncertain tSsk.
Benjamin Raab, M.D. Allan L. Lorincz, M.D. University of Chicago Pritzker School of Medicine Chicago, IL 60637
ificity of herpes simplex virus thymidine kinase confers acyclovir-resistance. Nature 289:81-83, 1981. 11. Comprehensive summary of pre-clinical studies. Mutagenicity studies in comprehensive information for investigators--Zovirax. Research Triangle Park, NC, October, 1980, Burroughs Wellcome Co., pp. 57-59.
A call f o r t w i n p a i r s w i t h psoriasis
To the Editor: In 1971, we applied the twin method to the study of the genetics of psoriasis. 1 Twelve years later, we are conducting a follow-up survey on the original twin participants. We would like to expand our basic twin population and are asking dermatologists to send us the names of patients who are monozygotic or dizygotic twins with psoriasis and who would be willing to complete a brief, confidential questionnaire. We would appreciate the cooperation of dermatologists and that of their twin patients in this effort.
Eugene M. Farber, M.D. Professor and Chairman Department of Dermatology Stanford University School of Medicine Stanford, CA 94305
REFERENCES
1. Raab B, Lorincz AL: Genital herpes simplex--concepts and treatment. ~ AM ACAD DERMATOL5: 249-263, 1981. 2. Thiers B: Unusual treatments for herpesvims infections. I. Herpes simplex. J AM ACAD DERMATOL 7:811-816, 1982. 3. Luby J: Therapy in genital herpes. N Engl J Med 306:1356-1357, 1982. (Editorial.) 4. Package insert: Prescribing instructions--Zovirax (acyclovir) ointment 5%. Research Triangle Park, NC, October, 1982, Burroughs Wellcome Co. 5. Sibrack CD, Gutman LT, Wilfert CM, et al: Pathogenicity of acyclovir-resistant herpes simplex virus type 1 from an immunodeficient child. J Infect Dis 146:673681, 1982. 6. Sibrack CD, McLaren C, Barry DW: Disease and latency characteristics of clinical herpes simplex virus isolates after acyclovir therapy. Am J Med 73(suppl A):372-375, 1982. 7. Schipper CE, Crumpacker CS: Resistance of herpes simplex virus to acycloguanosine: The role of viral thymidine kinase and DNA polymerase loci. Proc Natl Acad Sci USA 77:2270-2273, 1980. 8. Field HJ: Development of clinical resistance to acyclovir infected mice receiving oral therapy. Antimicrob Agents Chemother 21:744-752, 1982. 9. Field HJ, Darby G: Pathogenicity in mice of strains of herpes simplex virus which are resistant to acyclovir in vitro and in vivo. Antimicrob Agents Chemother 17:209-216, 1980. 10. Darby G, Field HJ, Salisbury SA: Altered substrate spec-
REFERENCE 1. Father EM, Nall ML, Watson W: The natural history of psoriasis in 61 twin pairs. Arch Dermatol 109:209-211, 1974.
Boric a c i d - f r e e p r o d u c t s
To the Editor: Since the publication of our report, "Boric Acid Poisoning" (J AM ACAD DERMATOL7:667-673, 1982), it has been brought to our attention that several products listed in Table I have been reformulated and no longer contain boric acid. In particular, the two mouthwashes, Listerine and Chloraseptic, have eliminated boric acid as an ingredient. Massengill powder has also been changed and no longer contains this ingredient. The other products on the list still contain boric acid, although for the most part in trace quantities as a preservative. It was not our intent to suggest that these boric acid-containing products are dangerous when used as directed, but merely that potential danger exists should these products be used in excessive amounts for indications other than those listed on the respective packaging.