Diagnosis and management of acyclovir-resistant herpes simplex virus for the dermatologist.

Patil, Mihir K; Zhao, Vivian; Nambudiri, Vinod E; Shi, Connie R · J Am Acad Dermatol · 2026

review · Level V

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Abstract

Acyclovir-resistant herpes simplex virus is uncommon but clinically significant, particularly in immunocompromised patients, in whom delayed recognition can lead to chronic nonhealing ulceration and disseminated disease. We review published guidelines on the recognition, confirmation, and management of acyclovir-resistant herpes simplex virus, including when to suspect resistance, susceptibility testing, and antivirals including foscarnet, cidofovir, and the emerging agent pritelivir.