To the Editor:

I would like to compliment the authors of "Treatment of Herpes Simplex Virus Protection: Rationale for Occlusion," which was published in the July 2007 issue of Advances in Skin & Wound Care. I commend them on this thoughtful review, presenting a rationale for use of occlusive dressings on orofacial Herpes simplex virus lesions. I would also like to ask if they think this rationale might also apply to varicella-zoster virus lesions (also called herpes zoster or shingles)? The 2 conditions share many parallels in patient discomfort and healing progression.

The only literature I have been able find on the topic of dressing shingles' lesions with occlusive dressings were 3 case studies combining appropriate systemic antiviral therapy with primary hydrocolloid1,2 or absorbent silicone3 dressings. Authors reported improved patient comfort, autolysis of necrotic tissue (in 1 case1 with an initial 3-day application of an amorphous hydrogel), reduced patient-reported itching and pain, and protection of the lesions from damage and secondary infection resulting from patient scratching.

For perspective, healing time ranged from 2 to 3 weeks after initial presentation in patients dressed with hydrocolloid dressings to 5 months for the patient dressed with the absorbent silicone dressing; however, variables other than dressing, such as time from lesion onset or patient condition, are likely to have accounted for these variations in reported healing time.

Laura L. Bolton, PhD

References