acyclovir and Dermatitis

Noncontiguous multidermatomal herpes zoster is very rare in both immunocompetent and immunocompromised persons. Most of the reported cases have been limited to 2 noncontiguous dermatomes. This unique presentation has been referred to as zoster duplex unilateralis or bilateralis, depending on whether one or both halves of the body are involved. Granulomatous dermatitis at sites of herpes zoster scars, a rare isotopic response, has only been reported in persons with contiguous dermatomes of zoster. We describe an immunocompromised patient who developed herpes zoster in 7 disparate dermatomes. Three months after resolution of the zoster, the patient developed a granulomatous dermatitis in a zosteriform distribution at the sites of previous infection.

Topics: 2-Aminopurine; Acyclovir; Aged; Antiviral Agents; Dermatitis; Famciclovir; Granuloma; Herpes Zoster; Humans; Immunocompromised Host; Kidney Transplantation; Male; Prodrugs; Skin Diseases, Viral

Topics: Acyclovir; Antiviral Agents; Dermatitis; Herpes Zoster; Herpesvirus 3, Human; Humans; Valacyclovir

Topics: Acyclovir; Adenine; Adult; Antiviral Agents; Chickenpox; Dermatitis; Fever; Humans; Leukemia, Lymphocytic, Chronic, B-Cell; Male; Piperidines; Pyrazoles; Pyrimidines

Cutaneous eruptive xanthomas are characteristics lesions of hyperlipidemia. Rarely,these lesions may present with prominent leukocytoclasis as seen in papular neutrophilic xanthomas, which have been described in HIV positive and immunocompromised patients. Herein we describe a patient with eruptive neutrophilic xanthomas with neither hyperlipidemia nor immunocompromise. Moreover, these lesions improved with sun and UV light exposure.

Topics: Acyclovir; Anemia; Clobetasol; Colchicine; Dermatitis; Humans; Male; Middle Aged; Neutrophils; Prednisone; Pruritus; Testosterone; Ultraviolet Therapy; Valacyclovir; Valine; Xanthomatosis

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

Famciclovir (FCV) and valaciclovir (VACV) have previously been shown to be potent inhibitors of herpes simplex virus type 1 (HSV-1) in a murine cutaneous model. In the present study, mice were inoculated in the skin of the left ear pinna with herpes simplex virus (HSV) type 1. Antiviral therapy was started on different days postinoculation (p.i.), terminating at the end of day 10 p.i. The compounds were administered twice daily by oral gavage at 50 mg/kg of body weight/dose. Mice were sampled on day 5 p.i., during the acute phase of the infection, and the titers of infectious virus in the target tissues (ear, brain stem, and trigeminal ganglia) were determined. At 2 to 3 months p.i., the ipsilateral and contralateral trigeminal and cervical dorsal root ganglia were explanted, and four different methods were used to detect latent HSV. The methods were (i) conventional explant culture for 5 days followed by homogenization, (ii) long-term culture (up to 73 days) of whole ganglia, followed by homogenization, (iii) dissociation by enzymatic disaggregation and an infectious center assay, and (iv) in situ hybridization to detect latency-associated transcripts (LATs). The conventional explant culture method was the least sensitive method, while in situ staining for LAT was the most sensitive, and all mice, including those treated from early times with FCV, were shown to be latently infected. Significantly less latent virus was detected by all four methods, however, in ganglia obtained from mice that had been treated with FCV in comparison with the amount detected in ganglia from mice that had been treated with VACV. However, in no case was latency completely eliminated.

Topics: 2-Aminopurine; Acyclovir; Animals; Antiviral Agents; Body Weight; Brain; Cell Culture Techniques; Dermatitis; Ear; Famciclovir; Female; Herpes Simplex; Herpesvirus 1, Human; In Situ Hybridization; Mice; Mice, Inbred BALB C; Neurons; Trigeminal Ganglion; Valacyclovir; Valine; Virus Latency

Urinary retention is uncommon in patients with herpes zoster and anogenital herpes simplex. Seven patients (four men, three women) with a mean age of 68.1 years (range, 35-84) with urinary retention due to herpes zoster (n = 6) or anogenital herpes simplex (n = 1) were studied. Six patients had unilateral skin eruption in the saddle area (S2-4 dermatome) and one patient with herpes zoster had a skin lesion in the L4-5 dermatome. All patients had detrusor areflexia without bladder sensation, and two of them had inactive external sphincter on electromyography at presentation. Clean intermittent catheterization was performed, and voiding function was recovered in 4-6 weeks (average, 5.4) in all patients. Urodynamic study was repeated after recovery of micturition in three patients, and they returned to normal on cystometrography and external sphincter electromyography. Acute urinary retention associated with anogenital herpes infection has been thought to occur when the meninges or sacral spinal ganglia were involved, and, in conclusion, this condition may be considered to be reversible.

Topics: Acyclovir; Adult; Aged; Aged, 80 and over; Anal Canal; Antiviral Agents; Dermatitis; Female; Genitalia; Herpes Simplex; Herpes Zoster; Humans; Male; Middle Aged; Treatment Outcome; Urinary Retention; Urination; Urodynamics

Topics: Acyclovir; Antiviral Agents; Dermatitis; Diagnosis, Differential; Herpes Simplex; Humans; Infant, Newborn; Lung; Male; Pneumonia, Viral; Radiography; Respiration Disorders; Time Factors

To describe the clinical course of varicella-zoster optic neuropathy preceding acute retinal necrosis in patients with acquired immunodeficiency syndrome.. Case series.. Two tertiary care centers in San Diego, Calif, and London, England.. Three human immunodeficiency virus-positive men with previous cutaneous zoster infection, optic neuropathy, and necrotizing retinitis.. All patients had an episode of zoster dermatitis treated with acyclovir. Visual loss consistent with an optic neuropathy ensued, followed by typical herpetic retinitis. The cause of visual loss was not suspected to be varicella-zoster until after the retinitis occurred. Despite aggressive medical treatment, 4 of 6 eyes progressed to retinal detachment.. Varicella-zoster may cause an optic neuropathy in patients with acquired immunodeficiency syndrome, especially in those with previous shingles. A high index of suspicion is necessary to establish the diagnosis and begin early antizoster treatment.

Topics: Acyclovir; Adult; AIDS-Related Opportunistic Infections; Antigens, Viral; Antiviral Agents; Dermatitis; Fluorescein Angiography; Fundus Oculi; Herpes Zoster; Herpes Zoster Ophthalmicus; Herpesvirus 3, Human; Humans; Immunohistochemistry; Male; Middle Aged; Optic Nerve Diseases; Retina; Retinal Necrosis Syndrome, Acute; Skin Diseases, Viral; Visual Acuity; Vitreous Body

Herpes simplex infection of the hand is often falsely diagnosed as a pyogenic paronychia or felon and treated as such, because the clinical picture is not known and pathogen isolation is difficult. However, the surgical treatment of herpes digitalis is contraindicated, since it promotes the development of superinfections and triggers recurrence. The pathogen can be isolated in cell cultures prepared from the vesicle contents or a smear from the vesicle base. Serological antibody testing is unreliable. Topical application of Acyclovir cream (Zovirax) is the treatment of choice.

Topics: Acyclovir; Administration, Topical; Adult; Dermatitis; Diagnosis, Differential; Herpes Simplex; Humans; Male; Paronychia; Recurrence

We treated two patients with herpes zoster ophthalmicus in whom hyphema and hemorrhagic glaucoma occurred. Case 1 complained of facial skin eruption, and was given intravenous acyclovir for 7 days. Hyphema and high intraocular pressure occurred in the left eye 10 days after the onset of the skin eruption. Case 2 had severe pain and blisters on her face, and was given intravenous acyclovir for 7 days. An intracameral hemorrhage and glaucoma developed in the right eye 15 days after the onset of the skin lesion. Intravenous acyclovir may be necessary for longer than 7-day periods if the iridocyclitis remains.

Topics: Acyclovir; Aged; Aged, 80 and over; Dermatitis; Eye Diseases; Face; Glaucoma; Hemorrhage; Herpes Zoster Ophthalmicus; Humans; Hyphema; Injections, Intravenous; Male