In 1952, . Peterson and . Murray of Upjohn developed a process that used Rhizopus mold to oxidize progesterone into a compound that was readily converted to cortisone.  The ability to cheaply synthesize large quantities of cortisone from the diosgenin in yams resulted in a rapid drop in price to US $6 per gram, falling to $ per gram by 1980. Percy Julian's research also aided progress in the field.  The exact nature of cortisone's anti-inflammatory action remained a mystery for years after, however, until the leukocyte adhesion cascade and the role of phospholipase A2 in the production of prostaglandins and leukotrienes was fully understood in the early 1980s.
Oral acyclovir is extremely useful in managing HSV infections in HIV-infected patients. In the immunocompetent HIV-infected patient, either intermittent or chronic suppressive therapy may be used. The immunosuppressed patient with chronic ulcerative lesions should receive acyclovir (200 to 400 mg orally 5 times daily) until the ulcers heal, which may take several weeks. Then, chronic suppressive therapy should be instituted with acyclovir (400 mg orally twice daily) to reduce recurrences. The newer acyclovir analog antiviral agents are available with better absorption and higher bioavailability. Famciclovir (250 mg 3 times daily) and valaciclovir (100 mg twice daily) are alternatives.
Systemic corticosteroids can reactivate tuberculosis and should not be used in patients with a history of active tuberculosis, except when chemoprophylaxis is instituted concomitantly. The incidence or course of acute bacterial infection are probably minimally affected by inhaled triamcinolone. Application of topical corticosteroids to areas of infection, including tuberculosis of the skin, should be initiated or continued only if the appropriate antiinfective treatment is instituted. If the infection does not respond to the antimicrobial therapy, the concurrent use of the topical corticosteroid should be discontinued until the infection is controlled.