acyclovir and Urticaria

Topics: Acyclovir; Antibodies, Viral; Antigens, Viral; Antiviral Agents; Capsid Proteins; DNA, Viral; Epstein-Barr Virus Infections; Female; Herpesvirus 4, Human; Histamine Antagonists; Humans; Prednisone; Remission, Spontaneous; Urticaria; Virus Activation; Young Adult

The role of infectious agents as a cause of chronic idiopathic urticaria (CIU) is uncertain. The objective of this study was to investigate whether genital herpes simplex infection is causally related to CIU. We identified two patients with recurrent genital herpes simplex infections associated with CIU. Episodes of genital herpes were especially associated with acute exacerbation of urticaria. Anti-herpes simplex 2 antibodies and Tzanck smears were done in both patients, along with other relevant investigations for CIU. Acyclovir was added to antihistamine therapy. Both patients were apparently in good health and appeared clinically immunologically stable, though one of them was found to be diabetic. Clinical and laboratory investigations for genital lesions supported a diagnosis of herpes simplex. Anti-herpes simplex 2 antibodies were markedly raised in both patients. The Tzanck smear was positive in one case and negative in the other, despite a definitive clinical diagnosis of herpes progenitalis. CIU, which was inadequately controlled with antihistamines alone, responded dramatically to the addition of acyclovir therapy. Our results may not be applicable to other patients with CIU, especially when there is inadequate evidence of an association with genital herpes. CIU may be associated with recurrent genital herpes simplex infection. In such situations, the addition of acyclovir to therapy may be beneficial.

Topics: Acyclovir; Adult; Antiviral Agents; Chronic Disease; Herpes Genitalis; Histamine Antagonists; Humans; Male; Middle Aged; Recurrence; Treatment Outcome; Urticaria

Topics: Acyclovir; Adult; Antiviral Agents; Female; Herpes Genitalis; Humans; Recurrence; Urticaria; Valacyclovir; Valine

Angioedema and chronic urticaria result from a variety of causes. Our purpose was to study the therapeutic effect of oral acyclovir on selected patients, by observing the effect of acyclovir in a dosage of from 100 mg every six hours to 800 mg every four hours in fourteen patients with angioedema or chronic urticaria. Five of twelve patients with chronic urticaria and one patient each with hereditary angioedema and idiopathic angioedema noted complete remission with acyclovir therapy. Discontinuation of the acyclovir resulted in reappearance of the hives. Since these patients had high antibody titers to either herpes simplex virus or Epstein-Barr virus, we conclude that acyclovir produced its therapeutic effect by suppressing a circulating viral antigen.

Topics: Acyclovir; Adult; Aged; Angioedema; Antiviral Agents; Chronic Disease; Female; Follow-Up Studies; Humans; Infant; Male; Middle Aged; Prognosis; Urticaria

Topics: Acyclovir; Female; Herpes Genitalis; Herpesvirus 2, Human; Humans; Middle Aged; Urticaria

Topics: Acyclovir; Administration, Topical; Adult; Dermatitis, Contact; Female; Humans; Infusions, Intravenous; Urticaria