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Biomedical subjects

A Barbaud

Publications and source records attributed to A Barbaud.

At least 55 records · Page 3Linked to original sources
PubMed2003

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

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.

Acyclovir↗
PubMed2003

[Physical urticarias].

Ten percent of chronic urticarias are physical urticarias. Patients suffering from physical urticaria all have a suggestive history with specific eliciting stimuli (cold, heat, water, sun.) and wheals in the areas where the stimulus acts. The involved pathomechanisms are not well known. An unknown allergen (related to a cold or a heat injury, a polar molecule contained in the stratum corneum and soluble into water, a photoallergen) could induce a mast cell mediator release, followed by an infiltration by eosinophil then neutrophils polymorphonuclears. T-cells are not highly involved. Dermographism, the most frequent can be cured by anti-H1. In diagnosing cholinergic urticaria physical exercise has to be done by the patient (jogging, running, riding), anti-H1 are efficient. In other physical urticarias (delayed-pressure, cold, solar, heat, vibratory urticarias) as to be managed as follows: (1) to perform specific tests with respectively (weights; ice cube; UVA, UVB and visible light exposure; hot water contained in a tube; a vortex mixer); (2) to avoid eliciting stimuli; (3) to treat the associated diseases e.g. in secondary cold urticaria; (4) to try to induce a physical tolerance, a review is enclosed concerning cold, solar, heat and aquagenic urticarias; (5) to associate or not non sedative 2(nd) generation antihistamines. All the other alternative treatments are discussed but none of them has been evaluated.

Anti-Allergic Agents↗
PubMed2002

[Pulmonary tuberculosis presenting as tubercular lupus].

Pulmonary tuberculosis can be associated with skin manifestations. We report a case in which cutaneous tuberculous lesions were associated with asymptomatic pulmonary tuberculosis. A 15-year old woman had four cutaneous tumoral lesions on her face back, a few of which had evolved over a period of several years. They were asymptomatic nodular lesions, with rounded bumps, with, in places, cheloidal features. The biopsy specimen revealed non-caseating epithelioid granulomas with giant cells and the culture grew Mycobacterium tuberculosis. Cavitating pulmonary tuberculosis was then revealed by CT scan and acid-fast bacilli were isolated in her sputum. The skin lesions disappeared with anti-tuberculosis therapy. Cutaneous manifestations of tuberculosis are rare, polymorphous, and can be associated with an underlying visceral infection. Lupus vulgaris is the most common cutaneous manifestation of tuberculosis in industrialised countries, but nevertheless it remains rare and it is a very unusual presenting feature of underlying pulmonary tuberculosis.

Adolescent↗