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Allergic reactions related to drugs are hypersensitivity responses driven by the immune system and bear no connection to the drug's therapeutic action. While drugs in isolation do not trigger an immune response, they can interact with endogenous proteins to form antigens. These antigens stimulate lymphocytes to produce antibodies. IgE-type antibodies attach themselves to mast cells. Upon subsequent exposure to the same stimulus, the antigen-antibody interaction is initiated, unleashing...

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Drug-related allergies are immune-mediated responses triggered by the administration of pharmacological agents. These hypersensitivity reactions are classified based on the immune mechanisms involved. The four primary types—Type I, II, III, and IV—are mediated by different immunological pathways and exhibit distinct clinical manifestations.Type I Hypersensitivity/ IgE-Mediated Reactions: Immunoglobulin E (IgE) immediately mediates Type I hypersensitivity reactions. Upon initial...

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Type II hypersensitivity involves IgG and IgM antibodies targeting cell surface antigens, leading to cell destruction. This can occur through complement activation, antibody-dependent cell-mediated cytotoxicity (ADCC), or acting as opsonins for phagocytosis. When excessive, these reactions cause significant tissue damage.Drug-induced hemolytic anemia is a common example, where drugs like penicillin or cephalosporins bind to red blood cells, forming drug-protein complexes. These complexes...

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Type III hypersensitivity reactions occur when antigen–antibody complexes form and activate the complement system. Normally, these complexes help the clearance of antigens by phagocytes and red blood cells. However, when large numbers of immune complexes are present, they can deposit in tissues—particularly in the walls of blood vessels—leading to inflammation and tissue injury. These deposits trigger complement activation and neutrophil recruitment, resulting in serum...

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Allergic Contact Dermatitis from Topical Acyclovir: Case Series.

Anca Chiriac¹, Anca E Chiriac², Tudor Pinteala²

¹Department of Dermatology, Nicolina Medical Center, Iasi, Romania; Department of Dermato-Physiology, Apollonia University, Iasi, Romania.

The Journal of Emergency Medicine

|September 24, 2016

Summary

Allergic contact dermatitis from acyclovir is rare but can be misdiagnosed. Prompt patch testing is crucial for accurate diagnosis and management of this topical medication reaction.

Keywords:

acyclovir allergic contact dermatitis topical treatment

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Area of Science:

Dermatology
Allergology
Pharmacovigilance

Background:

Acyclovir is widely used orally and topically for viral infections.
Allergic contact dermatitis (ACD) to acyclovir is infrequently reported, with limited case studies.

Observation:

Two female patients developed ACD from topical acyclovir cream.
Patch testing confirmed acyclovir 2% cream as the allergen in both cases.

Findings:

ACD from topical acyclovir is a rare but significant adverse reaction.
Misdiagnosis is common due to the infrequency of reported cases.

Implications:

Emergency physicians and healthcare providers must consider topical acyclovir ACD in differential diagnoses.
Awareness and appropriate patch testing are essential for managing acyclovir-induced ACD.