Herpes Zoster duplex -zoster affecting 2 separate dermatome simultaneously- is a rare disease. A 65 year old man, healthy in the past, presented with severely painful grouped papulovesicles and hemorrhagic crusts on the erythematous base on the right forehead and nasal bridge(V-I dermatome) and left chest(T4 dermatome) with nearly simultaneous occurrence. Tzanck smear revealed multinucleated giant cells and biopsy taken from the chest lesion showed the features consistent with herpetic viral blister. He was treated with intravenous administration of acyclovir for 5 days and both lesions were markedly improved.
Acyclovir ; Administration, Intravenous ; Aged ; Biopsy ; Blister ; Forehead ; Giant Cells ; Herpes Zoster* ; Humans ; Rare Diseases ; Thorax

AIMTo prepare acyclovir liposome for improvement the entrapment efficiency and stability.

METHODSAcyclovir liposome was prepared by the reverse evaporating method. Surfactants such as sodium deoxycholate and oleic acid were added to optimize the conditions and technology of preparing acyclovir liposome. The entrapment efficiency and particle size of the acyclovir liposome were determined. The liposome stability was proved by centrifugal acceleration experiment.

RESULTSThe particle size of the acyclovir liposome was 219.8 nm with the polydispersity index of 0.158. The entrapment efficiency reached 65%. The liposome was stable.

CONCLUSIONThe results suggest that the conditions and technology are stable and practical to prepare the liposome with high entrapment efficient and stability.

Acyclovir ; administration & dosage ; Antiviral Agents ; administration & dosage ; Drug Carriers ; Drug Stability ; Liposomes ; chemistry ; Particle Size ; Technology, Pharmaceutical ; methods

OBJECTIVETo evaluate the clinical efficacy of intradermal injection of methylene blue for treatment of moderate to severe acute thoracic herpes zoster and prevention of postherpetica neuralgia in elderly patients.

METHODSSixty-four elderly patients with herpes zoster were randomized to receive a 10-day course of intradermal injection of methylene blue and lidocaine plus oral valaciclovir (group A, 32 cases) and intradermal injection of lidocaine plus oral valaciclovir (group B).Herpes evaluation index, pain rating index, incidence of postherpetic neuralgia, and comprehensive therapeutic effect were compared between the two groups at 11, 30 and 60 days after the treatment.

RESULTSThe baseline characteristics were comparable between the two groups (all P>0.05). Compared with that in group B, the time for no new blister formation, blister incrustation and decrustation, and pain relief was significantly shortened in group A (P<0.05) with also obviously lower pain intensity after the treatment. The incidence of postherpetic neuralgia was significantly lower in group A than in group B at 30 days (P<0.05), but not at 60 and 90 days after the treatment. The total clinical response rate was 93.8% in group A, much higher than that in group B (62.5%, P<0.05).

CONCLUSIONIntradermal injection of methylene blue can effectively shorten the disease course, reduce the pain intensity and prevent the development of postherpetic neuralgia in elderly patients with herpes zoster.

Acyclovir ; administration & dosage ; analogs & derivatives ; therapeutic use ; Aged ; Herpes Zoster ; complications ; Humans ; Incidence ; Injections, Intradermal ; Lidocaine ; administration & dosage ; therapeutic use ; Methylene Blue ; administration & dosage ; therapeutic use ; Neuralgia, Postherpetic ; therapy ; Pain Measurement ; Valine ; administration & dosage ; analogs & derivatives ; therapeutic use

Herpes zoster, an inflammatory human disease caused by varicella zoster virus, is characterized by papulovesicular lesions along the distribution of a sensory nerve. We experienced a herpes zoster in 23 day old premature infant. The papules were distributed on his skin corresponding to the dermatomes innervated by the left Th3-Th4. The diagnosis of herpes zoster was made with dermatomal distribution of typical skin lesions, pathologic findings of eosinophilic intranuclear body and multinucleated giant cells in skin lesion (biopsy specimen). Detection of VZV specific IgG and IgM in the sera of patient was carried out. He was successfully treated with topical and intravenous administration of acyclovir. We report this case with a review of related literatures.
Acyclovir ; Administration, Intravenous ; Diagnosis ; Eosinophils ; Giant Cells ; Herpes Zoster* ; Herpesvirus 3, Human ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Infant, Newborn ; Infant, Premature* ; Skin

AIMTo study the effects of various liposomes formulations and preparation methods on the stability of acyclovir palmitate (ACV-C16) liposomes on storage at 4 degrees C and 25 degrees C over a 6 months period.

METHODSThe mean particle size, Zeta potential, pH and leaking ratio of ACV-C16 liposomes were the parameters chosen to indicate the stability of liposomes. All of the parameters were compared among various lipid compositions [egg lecithin/cholesterol/hosphatidylserine (PC/CH/PS), egg lecithin/cholesterol/stearylamine (PC/CH/SA), egg lecithin/cholesterol/cholesteryl sulphate (PC/CH/CS), bovine brain ceramides/cholesterol/palmitic acid/cholesteryl sulphate (CM/CH/PA/CS)], different preparation methods (film dispersing, reverse phase evaporation, dehydration/rehydration), charges (positive, negative), as well as among multilamellar vesicles liposomes (MLV), large unilamellar vesicles liposomes (LUV) and dehydration/rehydration vesicles liposomes (DRV).

RESULTSAn analysis of various parameters led to the conclusion that the stability of liposomes followed the order of PC/CH/CS > CM/CH/PA/CS > PC/CH/PS > PC/CH/SA at the same storage conditions; the positively charged system showed the most unstable delivery system of liposomes as compared to the other three systems. As far as stability was concerned, LUV liposomes proved to be superior to MLV liposomes and DRV liposomes, and the modified reverse phase evaporation method of Szoka provided the best preparation method. The stability in systems was enhanced when systems were stored at 4 degrees C as compared to storage at 25 degrees C.

CONCLUSIONThe stability of liposomes was significantly interrelated with lipid composition of various liposomes, preparation method and different storage conditions.

Acyclovir ; administration & dosage ; Chemistry, Pharmaceutical ; Drug Carriers ; Drug Delivery Systems ; Drug Stability ; Liposomes ; chemistry ; Palmitates ; chemistry ; Particle Size ; Technology, Pharmaceutical ; methods

The investigation was aimed to determine prognostic factors related to postherpetic neuralgia (PHN), and treatment options for preventing PHN. The data showed 34 (17.0%) out of 188 patients with herpes zoster had severe pain after 4 weeks, and 22 (11.7%) after 8 weeks, compared with 109 (58.0%) at presentation. The age (>or=50 yr), surface area involved (>or=9%), and duration of severe pain (>or=4 weeks) might be the main factors that lead to PHN. On the other hand, gender, dermatomal distribution, accompanied systemic conditions, and interval between initial pain and initiation of treatment might not be implicated in PHN. The subjects were orally received antiviral (valacyclovir), tricyclic antidepressant (amitriptyline), and analgesic (ibuprofen) as the standard treatment in the group 1. In addition to the standard medication, lidocaine solution was sub- and/or perilesionally injected in the group 2, while lidocaine plus prilocaine cream was topically applied to the skin lesions in the group 3. The rates of PHN in the 3 treatment groups were not significantly different, suggesting adjuvant anesthetics may not be helpful to reduce the severity of pain.
Acyclovir/administration & dosage/*analogs & derivatives ; Adolescent ; Adult ; Aged ; Amitriptyline/administration & dosage ; Anti-Inflammatory Agents, Non-Steroidal/administration & dosage ; Antidepressive Agents, Tricyclic/administration & dosage ; Antiviral Agents/administration & dosage ; Child ; Drug Therapy, Combination ; Female ; Herpes Zoster/*complications/drug therapy/physiopathology ; Humans ; Ibuprofen/administration & dosage ; Male ; Middle Aged ; Neuralgia/drug therapy/*etiology/physiopathology/prevention & control ; Prognosis ; Time Factors ; Valine/administration & dosage/*analogs & derivatives

ABSTRAC: The therapeutic course of an aciclovir-induced acute renal dysfunctional patients was summarized. This had been relieved through a 15-day treatment with Western medicine but with a two-week protracted low fever that was cured by the authors using Chinese medicinal herbs for supplementing qi to support essence, nourishing yin to depress fire, clearing heat, and detoxicating. For the sake of providing a reference to clinical medication, the materials used for the disease were recorded and analyzed to explore the clinical characteristics of Chinese medicine treatment and prevention of anaphylaxis responses, such as the protracted low fever after acute renal dysfunction induced by overinfused aciclovir.
Acyclovir ; administration & dosage ; adverse effects ; Adult ; Antiviral Agents ; administration & dosage ; adverse effects ; Drug-Related Side Effects and Adverse Reactions ; therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Infusion Pumps ; Medicine, Chinese Traditional ; methods ; Phytotherapy ; Remission Induction

OBJECTIVETo compare the therapeutic effects of peripheral facial paralysis in acute stage by different interventions and explore the better treatments of peripheral facial paralysis.

METHODSOne hundred and thirty one cases of Bell's facial paralysis were randomly divided into three groups. In acupuncture group (44 cases), Dicang (ST 4), Jiache (ST 6), Hegu (LI 4), Yangbai (GB 14) and Taiyang (EX-HN 5), etc. were applied; in electroacupuncture group (45 cases), the selection of acupoints and needling method were same as those in acupuncture group, and the electroacupuncture therapy was applied on Dicang (ST 4), Xiaguan (ST 7), Yangbai (GB 14) and Taiyang (EX-HN 5) in acute stage; in medication and acupuncture group (42 cases), Prednisone and Acyclovir were taken by oral administration, Vitamin B1 and Vitamin B12, were applied by intramuscular injection in acute stage, and acupuncture was applied by the way which was same as that in acupuncture group during quiescent and recovery stages. The curative effects were evaluated by House-Brackmann Grading Scale, and the failed rates were observed by follow-up after one and three months.

RESULTSThe cured and markedly effective rates were 79.6% (35/44), 93.4% (42/45) and 78.6% (33/42) respectively in acupuncture group, electroacupuncture group and medication and acupuncture group, and the result in electroacupuncture group was superior to those in acupuncture group and medication and acupuncture group (P < 0.05). The cured rates above tympanichord were 54.2% (13/24), 85.2% (23/27) and 48.0% (12/25) in acupuncture group, electroacupuncture group and medication and acupuncture group, and the result in electroacupuncture group was superior to those in acupuncture group and medication and acupuncture group (P < 0.01). There was no significant differences of cured rates below tympanichord among three groups (P > 0.05); and the failed rate in electroacupuncture group was much lower than those in acupuncture group and medication and acupuncture group by follow-up after one and three months (all P < 0.01).

CONCLUSIONThe peripheral facial paralysis is effectively treated by electroacupuncture in acute stage, and it suggests that electroacupuncture should be applied early during the acupuncture treatment of peripheral facial paralysis.

Acupuncture Points ; Acupuncture Therapy ; Acyclovir ; administration & dosage ; Adolescent ; Adult ; Aged ; Electroacupuncture ; Facial Paralysis ; drug therapy ; pathology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Prednisone ; administration & dosage ; Treatment Outcome ; Young Adult

Encephalitis is known as a rare complication of varicella zoster virus (VZV) reactivation. It is usually regarded as a complication of a cutaneous infection in patients with impaired cellular immunity. The reported incidence of herpetic motor involvement range between 0.5 and 31%, but is possibly more frequent as the weakness is readily obscured by pain. A 53-years-old woman, who presented with severe shoulder pain, fever, headache and seizure, which developed the day after skin eruptions, also developed motor paresis 7 days after the seizure. Her cerebrospinal fluid (CSF) was VZV-Polymerase chain reaction (PCR) negative, but VZV specific IgG antibody positive, and her brain MRI was found to be normal. With the early diagnosis and proper treatment, such as intravenous administration of acyclovir, stellate ganglion block and Yamamoto New Scalp Stimulation (YNSS), the patient completely recovered, without psychoneurological sequelae. Herein, we present this case, with a discussion of the relevant literature on the incidence, pathophysiology, diagnosis and management of central nervous system VZV involvement.
Acyclovir ; Administration, Intravenous ; Brain ; Central Nervous System ; Cerebrospinal Fluid ; Diagnosis ; Early Diagnosis ; Encephalitis* ; Female ; Fever ; Headache ; Herpes Zoster* ; Herpesvirus 3, Human ; Humans ; Immunity, Cellular ; Immunoglobulin G ; Incidence ; Magnetic Resonance Imaging ; Paresis* ; Scalp ; Seizures ; Shoulder Pain ; Skin ; Stellate Ganglion

OBJECTIVETo observe the effect of electroacupuncture (EA) combined with ultraviolet therapy on herpes zoster at the acute stage and the impacts on serum interleukin 2 (IL-2), interleukin 6 (IL-6) and interleukin 10 (IL-10) in the patients.

METHODSThirty-four patients of herpes zoster were randomized into a medicine group and a combined therapy group, 17 cases in each one. In the medicine group, the intravenous drops with acyclovir injection, muscular injection with cobamamide and the topical with acyclovir ointment were applied. Additionally, TDP was radiated locally. In the combined therapy group, on the basis of the treatment as the medicine group, EA and ultraviolet therapy were supplemented. The duration of treatment was 10 days in the two groups. Before and after treatment, blister relief, incrustation time and the visible analogue scale (VAS) were recorded in the two groups. The clinical efficacy was assessed in the two groups and the levels of serum IL-2, IL-6 and IL-10 were determined in the two groups.

RESULTSIn the combined therapy group, the time of blister relief and incrustation was earlier apparently than that in the medicine group (both P<0.05). VAS score after treatment were reduced as compared with that before treatment in the two groups (both P<0.01), and the reducing amplitude in the combined therapy group was larger than that in the medicine group (P<0.01). The total effective rate was 94. 1% (16/17) in the combined therapy group, higher than 76.4% (13/17) in the medicine group (P<0.05). After treatment, IL-2 levels were increased as compared with those before treatment in the two groups (both P<0.05), the levels of IL-6 and IL-10 were reduced obviously as compared with those before treatment in the two groups (all P<0.01). After treatment, the levels of IL-6, IL-10 were reduced much more apparently in the combined therapy group as compared with those in the medicine group (both P<0.05).

CONCLUSIONEA combined with ultraviolet irradiation more rapidly and effectively relief the symptoms of herpes zoster, significantly relief pain, shorten the duration of sickness, improve the body immunity and reduce nerve injury.

Acyclovir ; administration & dosage ; Adult ; Combined Modality Therapy ; Electroacupuncture ; Female ; Herpes Zoster ; blood ; drug therapy ; therapy ; Humans ; Interleukin-10 ; blood ; Interleukin-2 ; blood ; Interleukin-6 ; blood ; Male ; Middle Aged ; Treatment Outcome ; Ultraviolet Therapy