Submited on: 13 Jul 2012 03:29:04 PM GMT
Published on: 14 Jul 2012 03:46:50 PM GMT
 

  • What are the main claims of the paper and how important are they?

    The author described  a case report of two sisters suffered from Darier’s disease complicated with persistent infection of HSV. The author used Tzanck test for  rapid diagnosis that was confirmed latter by neutralization test that confirm the HSV infection. The diseased case showed slow but successful response to the treatment with oral acyclovir as indicated clinically and  weekly monitoring using quick Tzanck test.


  • Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.

    The claims are not novel

     
    Nikkels AF, Beauthier F, Quatresooz P, Piérard GE. Fatal herpes simplex virus infection in Darier disease under corticotherapy. Eur J Dermatol. 2005 Jul-Aug;15(4):293-7.
    Nikkels AF, Delvenne P, Herfs M, Pierard GE. Occult herpes simplex virus colonization of bullous dermatitides. Am J Clin Dermatol. 2008;9(3):163-8.

  • Are the claims properly placed in the context of the previous literature?

    Yes


  • Do the results support the claims? If not, what other evidence is required?

    Yes


  • If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?

    No


  • Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?

    No, the author did not provide his methodology in a separate section. It is recommended to add a methodology section to the manuscript.


  • Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?

    Abstract:
    The author should remove the first statement or replace it by more informative one about the disease description. It is better to organize the abstract into background, methods, results and conclusions.

    Introduction:
    The introduction should state purpose of the work. A summary of the literature to indicate why this study was necessary and what it aimed to contribute to the field. Accordingly the author should rewrite the introduction keeping these issues in mind and should refer the information used in the introduction with references. It is better to add some information about the disease  frequency in Japan if such data is available. Introduction should contain cited references.

    Cases:
    Merge the two cases in one case instead of case 1 and case 2
    Comments section
    1. It is better to replace the word comments by discussion.
    2. In the comment, the author mentioned that the chronic, unremitting burden on patients due to these complications was revealed in a clinical review of 163 patients by Burge in 1992.7. The reference No 7 is not Burge and should be replaced by Burge and Wilkerson 1992. Please put the reference number between brackets.
    3. The author mention the modified preservative Giemsa stain  as described by  Shino 1993. Please remove this statement and you could describe how you made your test in the item methodology. When you cite a reference, please do not precede the author name by a title [Dr., Mr.,…etc].It is not necessary to mention the stability duration of the stain in the discussion section because you described a case report and you did not modify  this test.
    4. The author mentioned” These 2 cases demonstrate that DD may be complicated by persistent HSV infection rather than episodic infection as previously described. [Please add reference ]”
    5. The author mentioned ‘’Decreased areas of skin lesions may represent decreased she dding  [remove the space to be shedding]of the HSV, which is very important in controlling infectious disease [add reference]

    References:
    The authors used references from  1970-2004, I wonder if they be able to add recent ones, I found recent publications till 2012 in the pubMed. The authors should cite references  within the body of the manuscript between brackets.

    The first reference, the author wrote No. 1 twice.

    1. Craddock N, Dawson E, Burge S, Parfitt L, Mant B, Roberts Q, et al. The gene for Darier’s disease maps to chromosome 12q23-q24.1. Hum Mol Genet. 1993;2:1941-1943.


  • Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?

    Yes


  • Other Comments:

    For Journal manager:

    The figures appear only in the pdf version but not in the html version, I think that figures should appear in both version.

    Decision
    Accepted after making the required changes.

  • Competing interests:
    No
  • Invited by the author to review this article? :
    No
  • Have you previously published on this or a similar topic?:
    No
  • References:
    None
  • Experience and credentials in the specific area of science:

    I have 15 years experience in virology.

  • How to cite:  Anonymous.Partial Remission after Continuous Oral Acyclovir in Darier's Disease- Two Sisters in a Family [Review of the article 'Partial Remission after Continuous Oral Acyclovir in Darier's Disease- Two Sisters in a Family ' by Hsiao L].WebmedCentral 2012;3(7):WMCRW002102
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Dear Professor Nikkels: Thank you very much for reviewing my article about Darier’s Disease. I have also learned a great deal from your papers on HSV infection. Because the HSV is DNA virus and is replicated and assembled in the nucleus, viral replication results in cytopathic changes in the cells. “Nuclei have ground glass appearance due to accumulation of viral particles, which causes peripheral margination of chromatin” (). This observation is consistent with my opinion that the cytologic changes may reflect the severity of the HSV infection. I do not have the equipment to do IHC or PCR, so I did not specify whether the infection was HSV type 1 or 2. The antiviral agents used are effective for both types. The differential diagnosis with herpes zoster was made because the lesions were extensive, symmetrical, and bilateral. Treatment guidelines for primary and recurrent orolabial and genital HSV infections are established; however, treatment options for atypical cutaneous HSV infections, traumatic herpes, and eczema herpeticum are not firmly established and should be monitored using complementary viral identification techniques (Nikkels AF, Pierard GE. Treatment of muco-cutaneous presentation of herpes simplex virus infections. Am J Clin Dermatol 2002;3(7):475-487). In my case, the presence of the viral cytopathic changes detected using the QTT helped in deciding the necessity of continuous antiviral therapy. Compared with previous treatment without any improvement for nearly 10 years, the patients were happy with the improvement 3 months after it had been initiated. As the sample materials, including the epidermal sheet and vesicular content, are removed, cytologic changes in the follicular epithelium and dermis were seen. The case reported in DermAtlas demonstrated the changes in the follicular epithelium better. There is limitation of tissue removed by the QTT, but is not limited only in epidermis. Please find more information about this case, which is available at: . Ultraviolet B (UVB) was effective in treating a patient with psoriasis and refractory Hailey-Hailey disease (HHD) (Hayakawa K, Shiohara T. Coexistence of psoriasis and familial benign chronic pemphigus: efficacy of ultraviolet B treatment. Br J Dermatol 1999;140(2):374-375). The clinical and histological features of DD overlap with those of HHD. Because phototherapy is contraindicated for DD, I checked carefully on whether there was deterioration of the symptoms. The patients claimed that narrow-band UVB (NBUVB) therapy decreased itching, so it was continued. Hamada reported that another patient with refractory HHD was treated by NBUVB successfully (Hamada T, Umemura H, Aoyama Y, Iwatsuki K. Successful therapeutic use of targeted narrow-band ultraviolet B therapy for refractory Hailey-Hailey disease. Acta Derm Venereol 2012;93(1):110-111. doi: 10.2340/00015555-1390). There are reports of drug resistance after long-term use of antiviral agents. The symptoms and signs gradually subsided whenever acyclovir or valacyclovir was prescribed. Because the antiviral therapy was clinically effective, a drug resistance test was not done. Sincerely yours, Lily Hsiao, MD
Responded by Dr. Lily Hsiao on 29 Jan 2013 02:19:36 PM

  • What are the main claims of the paper and how important are they?

    This is an interesting study to show the relationship between Darier's disease and Herpes Simplex Virus 1 infection.


  • Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.

    Yes


  • Are the claims properly placed in the context of the previous literature?

    Yes


  • Do the results support the claims? If not, what other evidence is required?

    Yes


  • If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?

    Yes


  • Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?

    Yes


  • Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?

    Mol bio experiments should be added to the manuscript.


  • Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?

    It's a good study


  • Other Comments:

    Mol bio experiments should have been added to the manuscript to established the facts.

  • Competing interests:
    None
  • Invited by the author to review this article? :
    No
  • Have you previously published on this or a similar topic?:
    Yes
  • References:

    Journal of Virology, 2009 PLoS Pathogens, 2009 PLoS One, 2011

  • Experience and credentials in the specific area of science:
    None
  • How to cite:  Singh G .Partial Remission After Continuous Oral Acyclovir in Darier's Disease- Two Sisters in a Family[Review of the article 'Partial Remission after Continuous Oral Acyclovir in Darier's Disease- Two Sisters in a Family ' by Hsiao L].WebmedCentral 2012;3(7):WMCRW002092
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Interesting and Important
Posted by Anonymous Reviewer on 16 Jul 2012 05:22:39 AM GMT

  • What are the main claims of the paper and how important are they?

    1.  The study claims to have observed partial remission of HSV infection in two cases upon a continuous therapy with oral acyclovir;

    2.  The author also claims that because there is a partial remission, there may be a decrease in shedding of the virus, whence it has implications in controlling the disease, with specific reference to Darier's Disease.


  • Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.

    1.  Leroy D et al.  Acyclovir treatment ... Darier's Disease.  Dermatologica, 1983; 167 (4): 212 - 216. 

    2.  Parham et al.  Disseminated Herpes simplex ... oral acyclovir.  J Infect, 1985; 10 (1): 77 - 78. However, the condition for which the present author claims partial remission may be novel.


  • Are the claims properly placed in the context of the previous literature?

    To a certain extent, the claims seem to have been properly placed in the context of the previous literature.  However, a better literature survey would have added credence to the report.


  • Do the results support the claims? If not, what other evidence is required?

    Pre-treatment and post-treatment fiugres/pictures would have added more credibility to the author's claims.


  • If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?

    Since this is a case report, exhaustive details of both protocols & methodology may not be essential.


  • Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?

    NA


  • Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?

    As has been mentioned earlier, pre-treatment, and post-treatment pictures of the disease condition would have added credence. This is essential because the article is a case report and protcols & methodology may not be described in detail.


  • Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?

    Too early, since this is a case report.


  • Other Comments:

    1.  Studies on shedding of viruses is extremely important from a transmission perspective.  Hence, this article/case report assumes importance in the field of virology;

    2.  However, there are certain drawbacks noted in this case report by Dr. Lily Hsiao: Nowhere in the article/report, except for the title, is it indicated that Case 1 and Case 2 are related and belong to the same family.  This is important because Darier's Disease is indicated to be inherited. 

    3.  A note on whether the patients were sexually active at the time of treatment is also important as HSV is also sexually transmitted.

    4.  The article fails to indicate whether the infecting type is HSV-1 or HSV-2.

  • Competing interests:
    No
  • Invited by the author to review this article? :
    No
  • Have you previously published on this or a similar topic?:
    No
  • References:
  • Experience and credentials in the specific area of science:

    Virology/Immunology/Immunodiagnostics of Hepatitis C virus (HCV)

  • How to cite:  Anonymous.Interesting and Important[Review of the article 'Partial Remission after Continuous Oral Acyclovir in Darier's Disease- Two Sisters in a Family ' by Hsiao L].WebmedCentral 2012;3(7):WMCRW002089
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  • What are the main claims of the paper and how important are they?

    It's an interesting study to show the severity of Darier's Disease followed by Herpes Simples Virus 1 infection.


  • Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.

    Yes, it shows the correleation between Darier's Disease and Herpes infections and showed the methods of detection of this disease.


  • Are the claims properly placed in the context of the previous literature?

    Yes


  • Do the results support the claims? If not, what other evidence is required?

    Yes


  • If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?

    Yes


  • Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?

    Yes


  • Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?

    Molecular Biology studies should have been incorporated


  • Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?

    This is good one


  • Other Comments:

    It would have been good if authors could have done some recent molecular biology studies to established the facts in terms of severity of disease.

  • Competing interests:
    None
  • Invited by the author to review this article? :
    No
  • Have you previously published on this or a similar topic?:
    Yes
  • References:

    Journal of Virology, 2009 PloS Pathogens, 2009 PloS One, 2011

  • Experience and credentials in the specific area of science:
    None
  • How to cite:  Anonymous.Partial Remission after Continuous Oral Acyclovir in Darier's Disease- Two Sisters in a Family[Review of the article 'Partial Remission after Continuous Oral Acyclovir in Darier's Disease- Two Sisters in a Family ' by Hsiao L].WebmedCentral 2012;3(7):WMCRW002088
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