valacyclovir and Folliculitis

Topics: Adolescent; Diagnosis, Differential; Folliculitis; Forehead; Herpes Simplex; Herpesvirus 3, Human; Humans; Male; Risk Assessment; Severity of Illness Index; Treatment Outcome; Valacyclovir; Wrestling

Varicella zoster virus (VZV) is an uncommon cause of folliculitis. We present a case of a 29-year-old woman who presented with an atypical follicularly-based eruption localized to her inner thigh with an associated pain in her lower back and inner thigh prior to the papular eruption. She was successfully treated with valacyclovir 1,000 mg three times daily with no complications.

Topics: Acyclovir; Adult; Antibodies, Viral; Antiviral Agents; Biopsy; Female; Folliculitis; Herpes Zoster; Herpesvirus 3, Human; Humans; Skin; Thigh; Valacyclovir; Valine

Topics: Acyclovir; Adult; Antibodies, Monoclonal; Antiviral Agents; Crohn Disease; Diagnostic Errors; Female; Folliculitis; Herpes Simplex; Humans; Immunocompromised Host; Immunologic Factors; Infliximab; Perineum; Simplexvirus; Tumor Necrosis Factor-alpha; Valacyclovir; Valine; Virus Activation

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

Post herpes zoster (HZ) reactions have been associated with panoply of neoplastic, inflammatory, and fibro-inflammatory cutaneous disorders. Varicella zoster virus (VZV) DNA has not been identified in most of these reports. After an episode of HZ, a healthy, active 90-year-old female developed ulcerative nodules in the affected trigeminal V1 dermatome and the contra-lateral trigeminal region over a 1-year period. Excision and/or biopsy of all these lesions showed similar pathologic changes that consisted of herpetic folliculitis, adjacent dense mixed nodular lymphocytic infiltrates with germinal centers (cutaneous lymphoid hyperplasia (CLH)), and in the deeper excision specimens, an obliterative vasculitis of a vessel with smooth muscle in its wall. Immunophenotype analysis revealed a mixed, predominate T- and B-cell population without loss of pan-T cell antigens or aberrant expression by B cells of T-cell antigens. Polymerase chain reaction for herpetic DNA was positive for VZV DNA. Lymphocyte gene rearrangement analysis revealed 2 distinct, anatomically and chronologically, monoclonal B-cell populations and a monoclonal T-cell population in one nodule. Treatment with valacyclovir has lead to almost complete resolution of her cutaneous nodules after 6 months of therapy. In this case, it can be surmised that persistence of VZV infection and lack of effective cell-mediated immunity lead to development of both immunopathology (vasculitis) and excessive lymphoid cell proliferation (CLH).

Topics: Acyclovir; Aged, 80 and over; Antiviral Agents; Arteritis; Clone Cells; DNA, Viral; Female; Folliculitis; Herpes Zoster; Herpesvirus 3, Human; Humans; Immunophenotyping; Polymerase Chain Reaction; Pseudolymphoma; 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

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