Successful treatment of equine sarcoids by topical aciclovir application.
Authors: Stadler S, Kainzbauer C, Haralambus R, Brehm W, Hainisch E, Brandt S
Journal: The Veterinary record
Summary
# Editorial Summary: Aciclovir as a topical treatment for equine sarcoids Equine sarcoids remain challenging to treat, with high recurrence rates affecting many therapeutic approaches. Researchers at Tillysburg Equine Clinic investigated whether topical aciclovir 5% cream could effectively treat sarcoids by enrolling 22 horses with 47 lesions total (diagnosed via clinical examination and bovine papillomavirus typing) between 2006 and 2009, applying the cream daily for 2–6 months, with four cases receiving prior surgical debulking. All 47 sarcoids (100%) showed therapeutic response, with 32 lesions (68%) achieving complete regression and no recurrence documented during follow-up, whilst 15 lesions (32%) showed partial resolution, primarily those with significant depth. The findings suggest aciclovir warrants routine consideration for mild-type sarcoids managed topically, and may offer genuine value as an adjuvant post-surgical agent to reduce recurrence risk—a particularly relevant outcome given the frustration many practitioners encounter with conventional sarcoid management. Future work establishing optimal treatment duration, defining which lesion characteristics predict complete versus partial response, and clarifying aciclovir's antiviral mechanism in this context would strengthen its evidence base for wider clinical adoption.
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Practical Takeaways
- •Topical aciclovir cream offers a non-invasive treatment option for equine sarcoids, with two-thirds achieving complete resolution when applied daily for 2-6 months
- •Thicker, more established sarcoids may require surgical debulking prior to aciclovir therapy to optimize treatment outcomes
- •Consider aciclovir as first-line therapy for early-stage sarcoids to avoid surgical intervention, or combine with surgery for advanced cases
Key Findings
- •All 47 sarcoids (100%) responded to topical aciclovir 5% cream treatment over 2-6 months
- •Complete tumor regression achieved in 32 lesions (68%), with no recurrences reported
- •Incomplete resolution occurred in 15 lesions (32%), likely due to lesion thickness
- •Aciclovir showed efficacy as monotherapy for mild-type sarcoids and as adjuvant therapy combined with surgery