Rapid systemic valaciclovir reaction subsequent to aciclovir contact allergy

Drug patch testing in systemic cutaneous drug allergy

“…Cross-reactions between acyclovir, valacyclovir and famciclovir are frequent in patients suffering from CADR due to acyclovir (Lammintausta et al, 2001;Vernassiere et al, 2003). It could be due to common chemical structure, as the 2-aminopurine nucleus is also found in ganciclovir but not in foscarnet or cidofovir (Vernassiere et al, 2003).…”

“…Barbaud, unpublished data). Positive patch tests were obtained with ganciclovir diluted at 20% in water but negative with the drug diluted at 20% in petrolatum (Lammintausta et al, 2001). There are no extensive studies concerning the value of other vehicles used in drug patch tests.…”

“…Miscellaneous drugs have been reported as yielding CADR with positive drug patch tests (Barbaud et al, 1998b;Barbaud, 2003): acyclovir and valaciclovir (Lammintausta et al, 2001;Vernassiere et al, 2003), allylisopropylacetylurea in a FDE (Sakakibara et al, 2001), captopril (Barbaud et al, 1998b), cefcapene pivoxil (Kawada et al, 2001), celecoxib (Britschgi et al, 2001;Verbeiren et al, 2002), clobazam (Machet et al, 1992), codeine diluted at 1 and 5% in petrolatum (two negative controls) (Estrada et al, 2001), co-trimoxazole (Klein et al, 1995), cyamemazine (Barbaud et al, 1998b), diazepam (Felix and Comaish, 1974), diclofenac (Jonker and Bruynzeel, 2003;Romano et al, 1994), enoxoparin (Barbaud et al, 1998b), estrogens (Gonçalo et al, 1999), fluoroquinolones (Barbaud et al, 1998b;Rodriguez-Morales et al, 2001), fusafungine (Barbaud et al, 1998b), isoniazide at 50% in petrolatum (10 negative controls) (Rebello et al, 2001), Lamisil ® (Barbaud et al, 1998b), meprobamate (Barbaud et al, 2001a), metamizole at 1 and 10% in petrolatum (Gonzalo-Garijo et al, 2001;Quinones Estevez, 2001), mexiletine hydrochloride diluted at 10 and 20% in petrolatum (Sasaki et al, 2001), nystatin at 10% in petrolatum (10 negative controls) (Barranco et al, 2001), paracetamol (acetaminophen) (Mashiah and Brenner, 2003) and vancomycin at 0.005% in water (Bernedo et al, 2001).…”

Symmetrical Drug-Related Intertriginous and Flexural Exanthema Caused by Valacyclovir

“…Our case met all of these criteria, and the typical distribution of the eruptions was reproducibly confirmed by an oral provocation test. Although 7 cases of drug-related eruption from systemic acyclovir or valacyclovir have been described to date, SDRIFE due to acyclovir and/or valacyclovir has not been reported [6,7,8,9,10,11,12]. …”

Topical Delivery of Haptens: Methods of Modulation of the Cutaneous Permeability to Increase the Diagnosis of Allergic Contact Dermatitis

“…Allergic contact dermatitis caused by acyclovir is rare, with only 20 studies reported [46][47][48]. Because of the doubtful reactions with antiviral, especially acyclovir, and in view of the suggestive clinical history, we recommend the scratch-patch test followed by repeated open application test (ROAT).…”