Photoallergic contact dermatitis from Zovirax® cream

Rodríguez‐Serna, Mercedes; Saavedra-Velasco, Marcos; Miquel, Javier; Cuadra, J. de la; Aliaga, Adolfo

doi:10.1111/j.1600-0536.1999.tb06220.x

Cited by 15 publications

(3 citation statements)

References 8 publications

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“…Although photoallergic contact dermatitis has been considered to be uncommon (33), the literature cites several topical substances that give rise to it. Some substances may exceptionally have a photoallergenic effect as cadmium in tattoos (39), cinchocaine (40), certain NSAIDs such as fepradinol (41), flufenamic acid and etofenamate (42), Zovirax cream (43), and the sunscreen agent octyl triazone (44), but others do so frequently. De Groot et al (45) give a comprehensive list of topical photoallergens in drugs and cosmetics, although not all of the cases reported have been critically reviewed (46).…”

Section: The Photoallergensmentioning

confidence: 99%

Photoallergic contact dermatitis

Goossens

2004

Photoderm Photoimm Photomed

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Many topical photoallergic culprits have been reported in the literature, the most important of which are sunscreen agents and, recently, non-steroidal anti-inflammatory agents (NSAIDs). Not at all exceptional is the occurrence of photoaggravation and recurrent transient or even persistent light reactions on previously exposed as well as non-exposed areas (often sparing the original application site), particularly with the NSAID ketoprofen. Moreover, cross-reactions with chemically-related as well as non-chemically related molecules are common. The potentially misleading clinical features observed in some cases, the diversity of the casual substances identified, and the low frequency with which photopatch testing is carried out in general indicate that the occurrence of photoallergic contact dermatitis might well be underestimated.

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Section: The Photoallergensmentioning

confidence: 99%

Photoallergic contact dermatitis

Goossens

2004

Photoderm Photoimm Photomed

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“…Documented contact dermatitis from acyclovir was rare, with only 10 studies reported (6–15). Positive patch tests were confirmed to 5% aqueous acyclovir in 2 studies (6, 7) in which the patients developed vesicular eczematous eruptions after treating herpes simplex.…”

Section: Documented Casesmentioning

confidence: 99%

“…Corazza et al (13) noted a concomitant sensitization to hydroxypropyl cellulose from a transdermal patch and the similar chemical structure of propylene glycol in the antiviral cream. Rodriguez‐Serna et al (15) recorded the first case of photoallergic contact dermatitis from acyclovir cream after treatment for recurrent labial herpes simplex. Punctate keratopathy was observed in 2 of 58 patients receiving 3% ophthalmic ointment for treatment of herpetic keratitis and confirmed by patch tests (16).…”

Section: Documented Casesmentioning

confidence: 99%

Contact dermatitis from topical antiviral drugs

Holdiness

2001

Contact Dermatitis

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The literature has been reviewed for contact dermatitis from topical antiviral drugs. 15 agents have been identified including acyclovir, imiquimod, podophyllin, podofilox, cidofovir, penciclovir, vidarabine, idoxuridine, trifluridine, tromantadine, lamivudine, interferon intralesional injections and ophthalmic solution, fomivirsen and foscarnet intravitreal injections and ganciclovir intraocular implants. Patch testing has been documented in certain individuals and cross-sensitization has been observed to contribute significantly to some allergic reactions.Key words: antiviral drugs; contact dermatitis; patch test; adverse cutaneous reactions; cross-sensitivity; medicaments. C Munksgaard, 2001. Accepted for publication 4 December 2000Adverse cutaneous reactions following topical or injectable administration of antiviral drugs are an uncommonly observed entity. For the most part, skin eruptions are mild and transitory; however, systemic manifestations of varying intensity can occur and may sometimes be serious in nature. Even more rarely observed is the associated contact dermatitis following occupational or therapeutic exposure. Information concerning this aspect of antiviral therapy is sparse and scattered throughout the medical literature. A review of the available data identifies 15 agents including acyclovir, imiquimod, podophyllin, podofilox, cidofovir, penciclovir, vidarabine, idoxuridine, trifluridine, tromantadine, lamivudine, interferon intralesional injections and ophthalmic solution, fomivirsen and foscarnet intravitreal injections and ganciclovir intraocular implants.Epidemiological studies have indicated seroprevalence rates to herpes virus vary from 1% in college freshmen in Columbia, South Carolina, to 9% in women attending a student health center at the University of Washington, to 22% of women attending family planning clinics in Pennsylvania, to 46% of women attending a sexually transmitted disease clinic in Seattle, Washington (1). Human papillomavirus types 6,11,16,18,31,33,35,39,45, 51 and 52 have been found in the cervical epithelium of 50% of sexually active women (2). Types 6 and 11 account for 80% of genital condylomas; whereas, types 16 and 18 account for 80% of cervical cancers in the USA and UK. Thus, considering the number of individuals who receive antiviral chemotherapy, substantial potential exists for adverse cutaneous and contact related reactions to occur. Documented CasesAcyclovir Phlebitis and erythema occurred in 16% of individuals receiving acyclovir intravenously (3). Severe local inflammation leading to necrosis of the skin has occurred from extravasation of intravenously administered acyclovir and has been considered a toxic reaction (4). However, a recent observation was suggestive of an immunologically based mechanism, as evidenced by histological examination indicative of a leukocytoclastic vasculitis (5). Approximately 1% of these individuals have manifested encephalopathic changes including lethargy, obtundation, tremors, confusion, hallucinations, seizures and com...

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