valacyclovir and Facial-Dermatoses

The objective of this multicenter, randomized, double-blind, noninferiority trial was to investigate valacyclovir as treatment for facial herpes simplex virus (HSV) outbreaks. In total, 308 otherwise healthy outpatients self-initiated therapy with valacyclovir, either 1000 mg twice daily for 1 day or 500 mg twice daily for 3 days, for treatment of one facial HSV episode. Aborted lesions were the primary end point. Secondary end points included episode and pain resolution and lesion healing. By regimen (1 or 3 days), aborted lesions occurred in 42.2% versus 46.7% of patients, treatment difference, -4.5% (95% confidence interval, -16.3% to 7.4%; P=.49). Subgroup findings showed that about half the episodes aborted when therapy started during the prodrome/macule stages or within 6 h of first symptoms. Episode and pain resolved rapidly, with results similar for both treatments. Adverse events were infrequent and similar for the two regimens.

Topics: Acyclovir; Administration, Oral; Adolescent; Adult; Aged; Antiviral Agents; Denmark; Double-Blind Method; Drug Administration Schedule; Facial Dermatoses; Female; Finland; Herpes Simplex; Humans; Lithuania; Male; Middle Aged; Norway; Prodrugs; Time Factors; Treatment Outcome; Valacyclovir; Valine

Topics: Cosmetic Techniques; Dermal Fillers; Face; Facial Dermatoses; Female; Humans; Hyaluronic Acid; Middle Aged; Prednisone; Sweet Syndrome; Treatment Outcome; Valacyclovir

We report a 48 -year-old woman witherythrokeratoderma variabilis, which is a rarehereditary disorder of keratinization, who developednew, painful, blisters within her skin lesions. Thediagnosis of herpes simplex virus infection was madebased on the clinical history and histopathologicfeatures. She was successfully treated withprophylactic valacyclovir, and her herpetic outbreakshave halted. This case serves as a reminder thateven among the most rare skin disorders, commonsecondary complications may be easily overlooked.

Topics: Abdomen; Acyclovir; Antiviral Agents; Arm; Erythrokeratodermia Variabilis; Facial Dermatoses; Female; Herpes Simplex; Humans; Leg; Middle Aged; Simplexvirus; Thoracic Wall; Valacyclovir; Valine

Topics: Acyclovir; Administration, Oral; Adult; Antiviral Agents; Diagnosis, Differential; Facial Dermatoses; Female; Herpes Zoster; Humans; Valacyclovir; Valine

A male university student, 24 years of age, presented to his general practitioner because of a facial rash. He had a past history of eczema but no other significant past medical history and no allergies. He was not taking any regular medications.

Topics: Acyclovir; Antiviral Agents; Diagnosis, Differential; Exanthema; Facial Dermatoses; Humans; Kaposi Varicelliform Eruption; Male; Valacyclovir; Valine; Young Adult

A 33-year-old woman presented with a 5-year history of a relapsing erythematous, indurated plaque on the left cheek. Herpes simplex virus (HSV) immunostain revealed the presence of HSV in the follicular and perifollicular keratinocytes. After oral treatment with valaciclovir for a period of 3 months the lesion disappeared without leaving a scar. At the last check-up, no recurrence had occurred. Herpes folliculitis has various clinical presentations. In rare cases it mimics a pseudolymphoma, as was the case for this patient. A viral aetiology, such as HSV or varicella-zoster virus, should be considered in patients with folliculitis, especially when the condition does not respond to antibacterial and antifungal therapy.

Topics: Acyclovir; Adult; Antiviral Agents; Diagnosis, Differential; Facial Dermatoses; Female; Folliculitis; Herpes Simplex; Humans; Simplexvirus; Valacyclovir; Valine

A 35-year-old woman with a history of atopic diathesis presented to the emergency department with 2 weeks of widespread facial vesiculopustules and eroded vesicles. HSV-1 was found on viral culture and direct fluorescent antibody testing. She was diagnosed with eczema herpeticum, an uncommon and potentially life-threatening viral infection that arises in areas of pre-existing dermatosis. Antiviral treatment for eczema herpeticum is very effective, and should be instituted without delay to avoid significant morbidity and mortality.

Topics: Acyclovir; Adult; Antiviral Agents; Codeine; Dermatitis, Allergic Contact; Dermatitis, Atopic; Diagnostic Errors; Disease Susceptibility; Facial Dermatoses; Female; Floxacillin; Herpesvirus 1, Human; Humans; Kaposi Varicelliform Eruption; Morphine; Prednisone; Respiratory Hypersensitivity; Staphylococcal Skin Infections; Valacyclovir; Valine

Viral folliculitis is a rare disease usually caused by herpes simplex, herpes zoster and molluscum contagiosum in immune-compromised patients. An otherwise healthy 30 year old patient without history of herpes simplex contracted a folliculitis in the beard region after a flu-like illness. He had no oral or labial lesions but instead showed a crusty erythematous folliculitis confined to the beard region with small grouped vesicles on the neck and reactive cervical lymph nodes. Bacterial and mycological analysis from swabs were negative. The culture was positive for herpes simplex virus and the immune fluorescence showed HSV type 1. Systemic therapy with valaciclovir 2x 500 mg/d and lotio alba locally led to rapid improvement. When confronted with folliculitis, non-bacterial causes such as viral (herpes simplex, herpes zoster, molluscum contagiosum), mycological (pityrosporon, candida), demodex and eosinophilic follicultitis should be taken under consideration.

Topics: Acyclovir; Adult; Antiviral Agents; Facial Dermatoses; Fluorescent Antibody Technique; Folliculitis; Herpes Simplex; Humans; Male; Prodrugs; Skin; Valacyclovir; Valine

The purpose of this survey was to ascertain current management practices of French dermatologists treating immunocompetent patients with cutaneomucosal herpes (ocular herpes excluded) as a prelude to the French consensus conference on this topic.. A random sample of French dermatologists were invited to respond to a telephone interview: 928 dermatologists were contacted.. The 216 dermatologists who responded to the telephone interview provided care for five persons per month (pregnancy excluded) who consulted for orofacial or genital herpes. Nearly half of the dermatologists stated they do not talk about herpes spontaneously with their patients. When a suspect lesion is seen for the first time, 48 p. 100 of the dermatologists order one or two complementary exams. Their advice on prevention between partners basically concerns use of preservatives. Therapeutic attitudes vary depending on the type of herpes or the number of recurrences per year: 84 p. 100 of the dermatologists prescribe a specific antiviral treatment for patients with solar herpes. Virological proof of infection is not acquired in 84 p. 100 of the cases before initiating a long-term treatment for recurrence. The most widely used agents are valaciclovir 500 and aciclovir 200.. This survey demonstrates a certain degree of divergence from the recommendations of the consensus conference. The participation rate appears to be satisfactory, but herpes serology is ordered too often and antiviral agents are not used in compliance with current guidelines. This survey will be redone after diffusion of the guidelines in order to evaluate their impact.

Topics: Acyclovir; Antiviral Agents; Dermatology; Drug Therapy, Combination; Facial Dermatoses; France; Health Care Surveys; Herpes Genitalis; Herpes Labialis; Herpesvirus 1, Human; Herpesvirus 2, Human; Humans; Interviews as Topic; Practice Patterns, Physicians'; Surveys and Questionnaires; Valacyclovir; Valine

Topics: Acne Vulgaris; Acyclovir; Administration, Oral; Antiviral Agents; Diagnosis, Differential; Facial Dermatoses; Female; Folliculitis; Herpes Simplex; Humans; Middle Aged; Valacyclovir; Valine

Topics: Acyclovir; Aged; Antiviral Agents; Facial Dermatoses; Female; Herpes Simplex; Humans; Laser Therapy; Premedication; Rhytidoplasty; Valacyclovir; Valine; Virus Activation