acyclovir and Cicatrix

Osteonecrosis following herpes zoster infection is a rare but severe complication, and clinicians' awareness is important for early detection and management of this condition. A case of herpes zoster of the left maxillary division of the trigeminal nerve is reported in a young female having no concurrent predisposing factors, with accompanying rare complications of alveolar bone necrosis and rapid tooth exfoliation. Acyclovir was used to manage the case effectively. The previously reported similar cases in the literature have been reviewed and the pathophysiology of tooth exfoliation and osteonecrosis by varicella zoster viruses is discussed.

Topics: Acyclovir; Adult; Antiviral Agents; Cicatrix; Cranial Nerve Diseases; Facial Dermatoses; Female; Herpes Zoster; Herpesvirus 3, Human; Humans; Maxillary Diseases; Maxillary Nerve; Osteonecrosis; Tooth Loss; Virus Activation

Topics: Acyclovir; Administration, Oral; Administration, Topical; Adult; Antiviral Agents; Cicatrix; Dermatitis, Allergic Contact; Facial Dermatoses; Female; Gels; Herpes Labialis; Humans; Recurrence; Skin Cream

Fractional photothermolysis was initially introduced by Manstein in 2004 .Fractional CO2 laser technology introduced has allowed physicians to obtain good cosmetic results with a lower rate of complications than non-fractionated ablative laser treatment. However, adverse effects may still occur.Reported cases of HSV infection after fractional photothermolysis are rare. A 48-year-old woman with Fitzpatrick skin type III presented with a scar in her perioral area desiring esthetic improvement of her burn scar. She didn't have a history of recurrent herpes simplex virus (HSV) infection periorally. A fractionated resurfacing laser Quadralase (Candela) was used to treat her perioral burn scar. Two sessions were performed with a month interval. Five days after the second session of laser therapy even after she took antiviral prophylaxis based on valacyclovir 500mg twice daily 24 hours before the laser session and 3 days after, she presented with a rash on the perioral area preceded by pain. Correlation of the history and the clinical presentation was consistent with HSV reactivation. Treatment was initiated with acyclovir 10mg/kg/8h administered intravenously for 10 days with a clearing of her vesicular eruption. Fractional CO2 laser is a very safe procedure when used with accepted parameters. Early recognition, close monitoring and careful wound care will prevent long term sequelae when complications occur.

Topics: Acyclovir; Administration, Intravenous; Antibiotic Prophylaxis; Antiviral Agents; Burns; Cicatrix; Dose Fractionation, Radiation; Female; Follow-Up Studies; Herpes Simplex; Humans; Lasers, Gas; Low-Level Light Therapy; Middle Aged; Mouth; Simplexvirus; Treatment Outcome; Virus Activation

Topics: Acyclovir; Anti-HIV Agents; Cicatrix; Female; Herpes Simplex; Humans; Infant; Infant, Newborn; Skin Diseases, Vesiculobullous

Acne scars are a common concern in dermatology. Fractional CO2 laser resurfacing is a recent addition in our armamentarium of treatment options for acne scars and has been shown to be an excellent option for patients with atrophic acne scars. Patients with acne scars receiving fractional CO2 resurfacing usually have both the acne scars and surrounding unscarred areas treated in common practice. There has yet to be a study that looked at the implications of only focally treating the acne scars while leaving surrounding normal skin untreated.. To evaluate the safety and efficacy of a focal approach to fractional CO2 laser treatment for acne scars, coined "Focal Acne Scar Treatment" or "FAST". This retrospective case series was conducted at Schweiger Dermatology, in New York, NY, with patients treated from November 2011 through May 2012. Overall, six patients (ages 18 to 48) were treated with the fractional CO2 laser resurfacing, using a so called "FAST" technique treating only the acne scars and leaving normal skin untreated. Evaluation was based on physician and patient assessment of improvement at one week and four weeks post-treatment.. All six patients treated with the Focal Acne Scar Treatment technique of fractional CO2 laser resurfacing had significant improvement post treatment ranging from 40% to 70% as estimated by the treating dermatologist and patient at four weeks post treatment. Patient satisfaction was high following FAST method. Temporary post-inflammatory hyperpigmentation was seen in two patients but resolved after a single 1550 nm Erbium Glass fractional laser treatment.. The Focal Acne Scar Treatment technique is an effective method of improving the appearance of atrophic acne scars. Higher energy and density levels can be used when utilizing this technique, resulting in improved outcomes when compared with whole face fractional CO2 laser resurfacing. Healing is improved and faster with this technique and no increased incidence of permanent adverse events were found. More studies are needed to further evaluate this new technique.

Topics: Acne Vulgaris; Acyclovir; Adolescent; Adult; Antiviral Agents; Cicatrix; Female; Humans; Laser Therapy; Male; Middle Aged; Patient Satisfaction; Treatment Outcome; Young Adult

Topics: Acne Keloid; Acyclovir; Adult; Anti-HIV Agents; Antiviral Agents; Azithromycin; Black People; Cicatrix; Disease Susceptibility; Hair Follicle; Herpes Zoster; HIV Infections; Humans; Male; Neck; Sebaceous Glands; Triamcinolone Acetonide; Valacyclovir; Valine

Herpes zoster is a common dermatologic disease characterized by unilateral pain and vesicular lesions over the unilateral sensory dermatomes being caused by the reactivation of varicella zoster virus, and its incidence seems to be increasing recently. In case of involving the ganglion of the fifth cranial nerve (trigeminal nerve), it can descend down the affected nerve into the skin, then producing an eruption in the dermatome. Among the patients with this disease, about 40% to 50% had associated conditions such as diabetes mellitus, hypertension, pulmonary tuberculosis, liver diseases, peptic ulcer, hypothyroidism, or pharyngitis but rarely facial trauma. Generally, herpes zoster was commonly associated with systemic disorders, and the treatment duration was prolonged in associated diseases. However, herpes zoster occurring specifically at the site of previously traumatized facial bone has not yet been reported. Retrospective study of 1 case of herpes zoster with blow-out fracture, which had been treated with acyclovir and steroid, was done. Follow-up length was about 3 months. After treatment, the patient became stable, and there was no complication. We treated herpes zoster developing within a recent operative subciliary scar, and the case is presented with the review of literature. Finally, facial trauma or reconstruction of the orbital floor with alloplastic implant might be a risk factor for herpes zoster in traumatized patient.

Topics: Acyclovir; Adult; Antiviral Agents; Cicatrix; Herpes Zoster; Humans; Male; Orbital Fractures; Risk Factors

To report long term visual outcomes, complications and graft survival of patients undergoing deep anterior lamellar keratoplasty (DALK) to treat corneal scarring secondary to herpes simplex virus (HSV) keratitis.. Retrospective, non-comparative case series. 18 patients who underwent DALK for HSV keratitis related corneal scarring between January 2004 and February 2007 were included. DALK was performed by Anwar's big bubble technique. Data collected for analysis included preoperative characteristics, intraoperative complications and postoperative acuity, complications and subsequent operations.. Mean best corrected distance visual acuity (LogMAR) improved from 1.51 ± 0.90 preoperatively to 0.82 ± 0.85 at the last follow-up (p=0.05). 27% of patients with more than 4 years follow-up had a best corrected distance visual acuity of 6/12 or better and 64% were 6/24 or better. Six patients (33%) experienced a recurrence of HSV keratitis and 9 (50%) experienced an episode of graft rejection. There were five cases (28%) of graft failure, four of whom had had a previous episode of graft rejection. Logistic regression did not find an association with graft rejection, HSV recurrence, any other observed postoperative host corneal vascularisation and any postoperative complication. The majority of patients underwent a second operation with 50% requiring cataract surgery.. DALK for the treatment of HSV related corneal scarring is associated with a high percentage of postoperative complications. DALK in this context is also associated with a large percentage of secondary operations. Patients should be aware of this when giving informed consent for DALK to treat HSV related corneal scars.

Topics: Acyclovir; Antiviral Agents; Cicatrix; Corneal Transplantation; Female; Follow-Up Studies; Graft Rejection; Graft Survival; Humans; Intraocular Pressure; Kaplan-Meier Estimate; Keratitis, Herpetic; Male; Recurrence; Reoperation; Retrospective Studies; Risk Factors; Treatment Outcome; Visual Acuity

Topics: Acyclovir; Aged; Antiviral Agents; Biopsy; Cicatrix; Herpes Zoster; Humans; Male; Myelodysplastic Syndromes; Skin; Valacyclovir; Valine

A case of trigeminal herpes zoster (HZ) infection affecting the left maxillary and ophthalmic divisions of the fifth cranial nerve in an immuno-competent patient is presented. Extremely rare complications such as osteonecrosis, spontaneous tooth exfoliation, secondary osteomyelitis and facial scarring were observed. Sequestrectomy, aciclovir and erythromycin stearate were effectively used in managing the case.

Topics: Acyclovir; Adult; Anti-Bacterial Agents; Antiviral Agents; Cicatrix; Erythromycin; Facial Dermatoses; Herpes Zoster; Humans; Immunocompetence; Male; Maxillary Diseases; Osteomyelitis; Tooth Exfoliation; Trigeminal Nerve Diseases

Cutaneous lesions arising in herpes zoster (HZ) scars are rare. We report a 34-year-old woman with acute lymphoblastic leukemia underwent allogenic bone marrow transplant (BMT). Ten days after the BMT, she developed clusters of vesicles over the right neck, scapula, shoulder and chest. She was treated with intravenous acyclovir and foscarnet. One month after the vesiculous episode of HZ she showed 5 mm to 2 cm clustered flat violaceous lichenoid papules and confluent plaques within the HZ scars. Histopathologic examination revealed a inflammatory infiltrate present in the papillary dermis with granulomatous aggregated formed by histiocytes, multinucleated giant cells and lymphocytes. She was treated with topic steroids with significant improvement. Pathologic findings are similar to those of an unusual lichenoid reaction named "giant cell lichenoid dermatitis". We present the first reported case of giant cell lichenoid dermatitis at the sites of HZ scars.

Topics: Acyclovir; Adult; Antiviral Agents; Bone Marrow Transplantation; Cicatrix; Dermatitis; Female; Foscarnet; Giant Cells; Glucocorticoids; Graft vs Host Disease; Herpes Zoster; Humans; Lichenoid Eruptions; Precursor Cell Lymphoblastic Leukemia-Lymphoma

Eleven female patients are reported who underwent full-face resurfacing. Three patients were treated for cosmetic rhytids, five for residual acne scarring, and three for photoaging. There were no complications or side effects in this group of patients. Reepithelialization was achieved in an average of 9.3 days, and erythema disappeared in an average of 8.9 weeks. The UltraPulse carbon dioxide laser with computerized pattern generator (CPG) scanner allows a rapid, uniform laserbrasion. The sequence of the procedure involves close application of adjacent squares at 60 W, 200 to 300 ml, at moderate density. Skin preparation with Retin-A and bleaching agents is important for best wound healing. Postoperative wound care includes maintenance of a moist environment and Zovirax for herpes prophylaxis.

Topics: Acne Vulgaris; Acyclovir; Adult; Aged; Aged, 80 and over; Anti-Inflammatory Agents; Antiviral Agents; Carbon Dioxide; Cicatrix; Dexamethasone; Epithelium; Erythema; Facial Dermatoses; Female; Follow-Up Studies; Glycolates; Herpesviridae Infections; Humans; Hydroquinones; Keratolytic Agents; Laser Therapy; Middle Aged; Radiation-Protective Agents; Rhytidoplasty; Skin Aging; Skin Care; Therapy, Computer-Assisted; Tretinoin; Wound Healing

We report the case of a female infant with an intrauterine herpes simplex type II infection in zosteriform distribution. She was treated with several courses of intravenous acyclovir leading to healing of the skin with segmental scarring. This patient is unusual in that the infection occurred in zosteriform distribution without any evidence of systemic involvement.

Topics: Acyclovir; Antiviral Agents; Cicatrix; Female; Herpes Simplex; Humans; Infant, Newborn

Topics: Acyclovir; Adolescent; Chickenpox; Cicatrix; Humans; Superinfection

Infection of the cornea due to herpes simplex virus continues to be a problem for ophthalmologists despite treatment of the disease with antiviral drugs. These drugs are known to produce some toxic effects and prolonged administration is sometimes necessary. Using tensile strength measurements to assess tissue repair, healing of a 5 mm perforating corneal stromal incision was measured after treatment with different antiviral drugs four times a day for eighteen postoperative days. Results suggest that 3% adenine arabinoside, 3% acycloguanosine, 1% trifluorothymidine, and 1% iododesoxycytidine ointments do not delay (p greater than 0.05) normal stromal healing.

Topics: Acyclovir; Animals; Antiviral Agents; Bromodeoxycytidine; Cicatrix; Deoxycytidine; Keratitis, Dendritic; Rabbits; Tensile Strength; Trifluridine; Vidarabine; Wound Healing