Propylene glycol allergy from acyclovir cream with cross‐reactivity to hydroxypropyl cellulose in a transdermal estradiol system?

Corazza, Monica; Virgill, Annarosa; Mantovani, Lucia; Malfa, Wilma la

doi:10.1111/j.1600-0536.1993.tb03575.x

Cited by 23 publications

(11 citation statements)

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“…This could be because of ‘compound allergy’ (4) or due to the difficulty in obtaining sufficient penetration of acyclovir through the epidermis without the use of propylene glycol. Sensitization to Zovirax® cream can be due to the excipients' sodium lauryl sulfate and, especially, propylene glycol (5, 6), and more rarely due to acyclovir (7–9).…”

Section: Discussionmentioning

confidence: 99%

“…This could be because of 'compound allergy' (4) or due to the difficulty in obtaining sufficient penetration of acyclovir through the epidermis without the use of propylene glycol. Sensitization to Zovirax 1 cream can be due to the excipients' sodium lauryl sulfate and, especially, propylene glycol (5,6), and more rarely due to acyclovir (7)(8)(9). 20 cases of systemic reactions secondary to oral administration of acyclovir in patients in whom previous use of topical acyclovir was not known have been collected by Carrasco et al (10).…”

Section: Discussionmentioning

confidence: 99%

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Systemic acyclovir reaction subsequent to acyclovir contact allergy: which systemic antiviral drug should then be used?

et al. 2003

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Allergic contact dermatitis caused by acyclovir is rare. We report the 5th case of systemic acyclovir reaction subsequent to acyclovir contact dermatitis, with investigations made to determine an alternative antiviral treatment. A 23-year-old woman, after dermatitis while using Zovirax cream, went on to develop urticaria after oral acyclovir. Patch tests were performed with the components of Zovirax cream (acyclovir, propylene glycol and sodium lauryl sulfate) and with other antiviral drugs. Patch tests were positive to Zovirax cream, acyclovir, valacyclovir and propylene glycol. Patch and prick tests with famciclovir were negative, but its oral administration caused an itchy erythematous dermatitis on the trunk and extremities. Our patient developed a systemic acyclovir reaction subsequent to acyclovir allergic contact dermatitis, with cross-reactions to valacyclovir and famciclovir. Their common chemical structure is the 2-aminopurine nucleus. It is probably this part of the molecule that provokes both contact allergy and systemic reactions. The only antiviral drugs not having this core are foscarnet and cidofovir, and these could therefore be alternatives.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Systemic acyclovir reaction subsequent to acyclovir contact allergy: which systemic antiviral drug should then be used?

et al. 2003

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“…However, with the low bioavailability of acyclovir dispersed in petrolatum compared to dissolved in propylene glycol one has to be skeptical of the conclusions of these studies that the skin reactions were being attributed only to the vehicle components. 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.…”

Section: Documented Casesmentioning

confidence: 99%

“…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%

“…Sensitivity to acyclovir 1%–5% in petrolatum was observed in other studies following treatment for recurrent herpes simplex (8, 9). Bourezane et al (10) along with others (11–14) demonstrated negative patch testing to acyclovir 5% in petrolatum and suggested that most of the sensitivity to acyclovir cream was due to the vehicle components, including sodium lauryl sulfate and propylene glycol. However, with the low bioavailability of acyclovir dispersed in petrolatum compared to dissolved in propylene glycol one has to be skeptical of the conclusions of these studies that the skin reactions were being attributed only to the vehicle components.…”

Section: Documented Casesmentioning

confidence: 99%

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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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Propylenglykol [MAK Value Documentation in German language, 2007]

2012

The MAK‐Collection for Occupational Health and Safety

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Veröffentlicht in der Reihe Gesundheitsschädliche Arbeitsstoffe , 42. Lieferung, Ausgabe 2007 Der Artikel enthält folgende Kapitel: Allgemeiner Wirkungscharakter Wirkungsmechanismus Toxikokinetik und Metabolismus Aufnahme, Verteilung, Ausscheidung Metabolismus Erfahrungen beim Menschen Einmalige Exposition Wiederholte Exposition Wirkung auf Haut und Schleimhäute Allergene Wirkung Reproduktionstoxizität Genotoxizität Kanzerogenität Tierexperimentelle Befunde und In‐vitro‐Untersuchungen Akute Toxizität Subakute, subchronische und chronische Toxizität Wirkung auf Haut und Schleimhäute Allergene Wirkung Reproduktionstoxizität Genotoxizität Kanzerogenität Sonstige Wirkungen Bewertung

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Propylene glycol allergy from acyclovir cream with cross‐reactivity to hydroxypropyl cellulose in a transdermal estradiol system?

Cited by 23 publications

References 4 publications

Systemic acyclovir reaction subsequent to acyclovir contact allergy: which systemic antiviral drug should then be used?

Systemic acyclovir reaction subsequent to acyclovir contact allergy: which systemic antiviral drug should then be used?

Contact dermatitis from topical antiviral drugs

Propylenglykol [MAK Value Documentation in German language, 2007]

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