Laser therapy herpes, herpes simplex, zoster

 Photobiomodulation, Photomedicine, and Laser Surgery Volume 38, Number 4, 2020 ª Mary Ann Liebert, Inc. Pp. 232–236 DOI: 10.1089/photob.2019.4725

Antimicrobial Photodynamic Therapy Used as First Choice to Treat Herpes Zoster Virus Infection in Younger Patient: A Case Report

Susana Teitelbaum, DDS, MSc,1 Luciane Hiramatsu Azevedo, DDS, MSc, PhD,2 and Wilber Edison Bernaola-Paredes, DDS, MSc3 Abstract Background: Herpes zoster virus infection is commonly described as reactivation of the varicella zoster virus (VZV), which involves the trigeminal nerve branches and ganglia in the maxillofacial region. The ophthalmic branch is the most involved, whereas the maxillary (V2) and mandibular (V3) dermatomes are less commonly affected.

Objective: This report describes the positive clinical results of photodynamaic therapy (PDT), used as first choice treatment modality, in a younger female patient who showed a diagnosis of recurrent infection of VZV in the right cheek after five applications and without having undergone medical approach. Methods: PDT has been used to treat several infectious processes and pre-oncological intraoral and extra-oral lesions. Our first-choice treatment protocol, taking into account her medical record, was PDT until we obtained completely regression and recovery.

Results: On the third and fourth days after light irradiation, the energy was reduced to 4 J. At fifth day of light irradiation, complete recovery was clinically observed.

Conclusions: The treatment with low-intensity laser, for both aPDT and light irradiation, was effective and safe, resulting in decontamination and healing of the area of the affected lesion, and improvement in the signs and symptoms of herpes zoster virus.

Keywords: herpes zoster, photodynamic therapy, varicella zoster virus, photobiomodulation, herpes zoster treatment

Photomedicine and Laser Surgery Volume 30, Number 1, 2012

Pedro Jose Mun�oz Sanchez, D.D.S.,1 Jose´ Luis Capote Femenı´as, D.D.S.,1 Alejandro Dı´az Tejeda, D.D.S.,1 and Jan Tune´ r, D.D.S.2

Objective: The purpose of this work was to study the effect of low-level laser therapy (LLLT) on the healing and relapse intervals in patients with recurrent labial herpes simplex infections.

Background data: Several pharmaceuticals are available to reduce symptoms and improve healing of labial herpes, but only LLLT has been reported to significantly influence the length of the recurrence period.

Methods: In an initial study, 232 patients with herpes simplex type 1 virus symptoms were consecutively selected for either LLLT or conventional therapy, including acyclovir cream or tablets. One of the dentists was responsible for the diagnosis, a second dentist for the treatment, and and a third for the evaluation, to allow for a semi-blinded procedure. Patients in the laser group received 670-nm laser irradiation, 40mW, 1.6 J, 2.04 J/cm2, 51mW/cm2 per blister in the prodromal stage and 4.8 J in the crust and secondarily infected stages, plus 1.2 J at the C2�C3 vertebrae. Patients were monitored daily during the first week to control healing, and monthly for 1 year to check on recurrence. In a consecutive study, 322 patients receiving LLLT were followed during 5 years to observe the period of ocurrences.

Results: An obvious effect of LLLT was found for both initial healing and for the length of the recurrence periods.

Conclusion: LLLT of herpes simples virus 1 (HSV-1) appears to be an effective treatment modality without any observed side effects.

Investigative Dermatology. 1999; 113 (2): 221-223.

50 patients with recurrent perioral herpes simplex infections (at least once a month for more than 6 months) were treated with 690 nm, 80 mW laser, 48 J/cm2, in a double blind study. Patients received daily irradiations for two weeks, 10 treatments. The treatment was given in a recurrencefree period and the irradiation was given at the site of the original herpes simplex infection. If both lips were involved, both upper and lower lips were treated. Patients were monitored for 52 weeks. The mean recurrence-free interval in the laser group was 37.5 weeks (range; 2-52 weeks) and in the placebo group 3 weeks (range 1-20 weeks). No side effects were noted.

Post herpetic. neuralgia can he an extremely painful condition which in many cases proves resistant lo all the accepted forms of treatment. II is frequently most severe in the elderly and may persist for years with no predictable course. This trial was designed as a double blind assessment of the efficacy of low level laser therapy in the relief of the pain of post herpetic neuralgia with patients acting as their own controls. Admission to the trial was limited to patients with established post herpetic neuralgia of at least six months duration and who had shown little or no response to conventional methods of treatment. Measurements of pain intensity and distribution were noted over a period of eight treatments in two groups of patients each of which received tour consecutive laser treatments. The results ides demonstrate a significant reduction in both pain intensity and distribution following a course of low level laser therapy.

In the present study we evaluate the effects of laser irradiation on the area near the stellate ganglion on regional skin temperature and pain intensity in patients with postherpetic neuralgia. A double blind, crossover and placebo-controlled study was designed to deny the placebo effect of laser irradiation. Eight in patients (male 6, female 2) receiving laser therapy for pain attenuation were enrolled in the study after institutional approval and informed consent. Each patient received three sessions of treatment on a separate day in a randomised fashion. Three minutes irradiation with a 150 mW laser (session 1), 3 minutes irradiation with a 60 mW laser (session 2), and 3 minutes placebo treatment without laser irradiation Neither the patient nor the therapist was aware which session type was being applied until the end of the study. Regional skin temperature was evaluated by thermography of the forehead, and pain intensity was recorded using a visual analogue scale (VAS).

Measurement were performed before treatment, immediately after (0 minutes) then 5, 10, 15, and 30 min after treatment. Regional skin temperature increased following both 150 mW and 60mW laser irradiation, whereas no changes were obtained by placebo treatment. VAS decreased following both 150 mW and 60 mW laser treatments, but no changes in VAS were obtained by placebo treatment. These changes in the temperature and VAS were further dependent on the energy density, i.e the dose. Results demonstrate that laser irradiation near the stellate ganglion produces effects similar to stellate ganglion block. Our results clearly indicate that they are not placebo effects but true effects of laser irradiation.

Addressee for Correspondance: Toshikazu Hashimoto MD, Department of Anesthesia, I Hokkaido University I Hospital N15, W7, Kita-ku Sapporo, Japan
060. 3/97 Rep US $ 8-10 12 ©1997 by LT Publishers l. .K., Ltd. LASER THERAPY 1997:9:7-- 12

The efficacy of low reactive-level laser therapy (LLLT) for pain attenuation in patients with postherpetic neuralgia (PHN) was evaluated in 63 patients (25 males. 38 females with an average age of 69 years) managed at our pain clinic over the past four years. A double blind assessment of LLLT was also performed in 12 PHN patients. The LLLT system is a gallium aluminum arsenide (GaAlAs) diode laser (830 nm, 60 mW continuous wave). Pain scores (PS) were obtained using a linear analog scale (i) to 10))) before and after LLLT. The immediate effect after the initial LLLT was very good (PS: (}3) in 26, and good (PS: 7-4) in 30 patients. The longterm effect at the end of LLLT (the average number of treatments 36 + 12) resulted in no pain (PS: 0) in 12patients and slight pain (PS: 1-4) in 46 patients. No complications attributable to LLLT occurred. Although a placebo effect was observed, decreases in pain scores and increases of the body surface temperature by LLLT were significantly greater than those that occurred with the placebo treatment. Our results indicate that LLLT is a useful modality for pain attenuation in PHN patients and because LLLT is a noninvasive, painless and safe method of therapy, it is well acceptable by patients.

Addressee for correspondence: Osamu Kemmotsu, Department of Anaesthesiology,Hokkaido University School of Medicine, N- 15, W-7, Kita-ku, Sapporo 060,Japan. 0898-5901/91/020071-05$05.00 � 1991 by John Wiley & Sons, Ltd.

By Arturo Guerra Alfonso and Pedro José Muñoz, Clinic "Leonardo Fernández Sánchez" , Cienfuegos, Cuba. Email : This email address is being protected from spambots. You need JavaScript enabled to view it.

Herpes simplex is an illness caused by the human herpes virus types 1 and 2 that generally present a primary lesion, with periods of latency and a tendency to relapse. It is also known as Button of fever or Bladder of fever. According to the World Health Organisation (WHO) an international prevalence of about 60% is observed (1, 2).

An experimental study was carried out, where 232 patients affected by the Herpes simplex type 1 virus were treated. All patients attended the clinic "Leonardo Fernández" of the area 3 of the municipality of Cienfuegos, during the period of January 2001 to January 2003, with the objective of determining the time of recurrence of the labial Herpes in the groups, studied before and after treatment, and to evaluate the effectiveness of the Laser of low power in the treatment of the infection of the virus.

Two groups were selected (study and control) with 116 patients in each group, distributed and classified according to the clinical stage in which they went to consultation. In the study group the patients were offered treatment with a LASERMED 670 DL, a GaAlAs diode laser (30mW � 40 sec) in the prodromal stage and stage of vesicles; or (20mW � 2 min) in the crust stage and in lesions infected secondarily. To all these patients was also applied radiation among the vertebras C2-C3 where the resident ganglion of the virus is located during the latent periods (30mW - 30sec).

The control group was offered indicated treatment with antivirals (Aciclovir in cream and in pills) and other palliative therapies.

After having carried out the analysis of the data obtained, the following results were obtained:

Chart No. 1

The patients of the study group. Distribution according to the frequency of annual recurrence of the labial herpes before and after receiving treatment.

Table No.1

Distribution of the patients in the study group acc. to the frequency of annual recurrence of herpes after laser therapy.

When analyzing the chart No.1 it is observed that the groups of patients that had Labial Herpes with high frequencies of recurrence (after being treated with Laser and to wait one year to evaluate their effectiveness), reported recurrence for more elongated periods of time and 32 patients didn't even have any more recurrence.

Chart No.2

The patients of the control group. Distribution according to the annual recurrence frequency of the labial herpes before and after receiving treatment.

In the chart No. 2 the same previous aspects are reflected but in the control group. As can be observed the cases diminished in number, although discreetly; those that presented more recurrence and of equal number of recurrencies increased in number of patient in the periods of more lingering recurrence. In this group 2 patients reported not to have had more lesions during the analyzed year.

Chart No.3

The patients of both groups. Distribution according to the annual recurrence frequency of the labial herpes after receiving treatment.