Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0033774 (pruritus)
 14,546 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 35-year-old woman presented with a 1-week history of vesiculopustules on erythematous bases on and in proximity to her lips (Figure 1). The patient had noted burning and itching in the area of these vesiculo-pustules before they developed. She had no systematic symptoms and had not noted similar vesiculopustules in this location in the past. A Tzanck smear was done that revealed multinucleated giant cells. A viral culture was performed. The patient was diagnosed with herpes labialis and received valacyclovir 500 mg b.i.d. for 5 days. One week later, the eruption was noted to have resolved, at which time the results of the viral culture showed growth of Herpes Simplex Virus-1. Thereafter, the patient was lost to follow-up.
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PMID:Treatment options: herpes simplex viruses. 1613 12

The optimization of the method of preparation of idoxuridine (IDU) liposomes by the reverse phase evaporation (REV) method was carried out by three variables at three levels (3(3)) factorial design. The three independent variables selected were volume of organic phase (x1), volume of aqueous phase (x2), and drug/phosphatidylcholine/cholesterol in molar ratio (x3). Twenty-seven batches of IDU liposomes were prepared by the REV method and subjected to evaluation for percentage drug entrapment (PDE), size, and size distribution. A reduced polynomial equation was derived by multiple regression of the data of PDE and the transformed values of the three independent variables. Three contour plots at fixed level of-- 1 (low), 0 (medium), and 1 (high) of major contributing variable (x3) were plotted between x1 and x2 at predetermined PDE to understand the physical meaning of independent variables. Liposomal gels were prepared by dispersing optimized IDU liposomes in 2%w/w and 5%w/w (HPMC) K4M gel bases so as to contain 1%w/w IDU (LIG-1 and LIG-2, respectively). The percentage of drug retention (PDR) studies of optimized batch 14 (Lipo-14) and LIG-1 and LIG-2 were carried out at three different storage conditions (2-8 degrees C, 25 +/- 2 degrees C, and 37 degrees C). A comparative diffusion study of LIG-1 and LIG-2 with PIG-1 and PIG-2 (1%w/w IDU with components of liposome dispersed in 2%w/w and 5%w/w HPMC K4M gel bases, respectively), respectively, through human cadaver skin was conducted. A comparative double blind clinical pilot study of optimized LIG-2 gel was carried out for eight weeks and compared with PIG-2 on 20 Herpes simplex patients (10 patients each for HSV-1 and HSV-2, divided into two groups each of 5 patients). Batch 14 (Lipo-14) was found to have maximum PDE of 74.4%. The PDR study showed maximum drug retention at 2-8 degrees C. A significant increase in PDR (p<0.05) was observed in LIG-1 and LIG-2 when compared with Lipo-14 at all the three temperatures. In the diffusion studies, a significant (p<0.05) flux reduction; 3.5 times in LIG-1 when compared with PIG-1 and 2.3 times in LIG-2 when compared with PIG-2 was observed. Approximately 2.2- and 2.5-fold increase in skin drug retention in LIG-1 and LIG-2, respectively, was determined. A double blind clinical study demonstrated an approximately 2.0- and 1.6-fold increase in average percentage improvement in healing of the lesions in patients suffering from HSV-1 and HSV-2 diseases, respectively, when treated with LIG-2 compared with PIG-2. However, complete removal of lesions was not observed. Local side effects such as itching, burning, inflammation in HSV-1 and HSV-2, and burning micturation in HSV-2 associated with the use of PIG-2 were reduced considerably with the use of LIG-2. The findings of this investigation establish the role of the derived equation and plotted contour plots in predicting the values of independent variables for preparation of IDU liposomes by the REV method. The study also demonstrated that IDU liposomal gels retain more drug when compared with plain liposomes at all temperatures for the period of three months, while maximum PDR was found at refrigeration temperature. The skin retention of IDU was enhanced due to its entrapment in the liposomal vesicles. The clinical study suggested the improvement of therapeutic efficacy of IDU entrapped in liposomes in treatment of HSV-1 and HSV-2 patients.
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PMID:Topical liposomal gel of idoxuridine for the treatment of herpes simplex: pharmaceutical and clinical implications. 1545 33

There is now evidence for an association between the use of epidural morphine and reactivation of herpes simplex labialis (HSL). There are no studies that definitively demonstrate the relationship between HSL reactivation and spinal intrathecal morphine. To investigate this relationship, we randomized and prospectively studied 100 obstetric patients with a history of HSL undergoing cesarean delivery under spinal anesthesia. One group received intrathecal morphine plus IV morphine via patient-controlled analgesia (ITM+PCA group) for postoperative analgesia, and a second group received only IV morphine via patient-controlled analgesia for postoperative analgesia (PCA-only group). Patients were followed for a 30-day period. In the ITM+PCA group 19 (38%) patients had HSL reactivation whereas eight (16.6%) had HSL reactivation in the morphine PCA-only group (P = 0.028). The incidence of pruritus in the ITM+PCA group was also more frequent in the early postoperative period. Our data show HSL reactivation in both the ITM+PCA group and PCA-only morphine group, with a more frequent incidence in the ITM+PCA group.
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PMID:Oral herpes simplex reactivation after intrathecal morphine: a prospective randomized trial in an obstetric population. 1584 9

A 60-year-old woman presented to our clinic with a complaint of a dermatitis that had recurred 2 or 3 times a month for the past 5 years. No trigger episode or obvious pattern of recurrence was noted. She reported some itching or burning as a prodromal symptom. Recurrence has been at multiple sites, in a dermatome pattern, including areas around the arm, face, back, abdomen, knees, and ears. Each occurrence is at a different anatomic site (and she only has lesions at this 1 site during each occurrence. For example, after formation and resolution at 1 site (ie, the right medial forearm) the patient will then have a later recurrence at another site (ie, the upper left part of the back). The patient has no complaints of fevers, chills, or adenopathy. Medical history includes type 2 diabetes and hypertension. Results of a basic laboratory screening at the time were all within normal limits. No other contributory history was noted. On examination, the medial arm just proximal to the elbow had clusters of vesicles (Figure). Viral culture performed on the lesion confirmed our suspicion of the presence of herpes simplex virus (HSV). The patient was started on valacyclovir and asked to return if no improvement was noted. To date the patient has not returned to the clinic.
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PMID:One hundred twenty recurrences of herpes simplex virus in an immunocompetent patient. 1761 75

Herpetic whitlow is a painful cutaneous infection that most commonly affects the distal phalanx of the fingers and occasionally the toes. It is caused by herpes simplex virus (HSV) types 1 or 2. Herpetic whitlow has been known mainly for infecting healthcare workers in contact with infected secretions or mucous membranes, but the implementation of universal precautions has resulted in a decrease in the incidence of occupation-related cases. Herpetic whitlow occurs mainly in adults aged 20 to 30 years and children. In children, most cases can be attributed to autoinoculation of HSV-1, while in adolescents and adults, herpetic whitlow tends to be caused by autoinoculation of HSV-2. Herpetic whitlow may have a prodrome of burning, pruritus, and/or tingling of the affected finger or the entire limb, followed by erythema, pain, and vesicle formation.
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PMID:Herpetic whitlow. 1767 83

Atopic dermatitis often requires long-term treatment. This European, multicentre, non-comparative, 24-month, follow-up study investigated the efficacy and safety of 0.1% tacrolimus ointment applied to adults with atopic dermatitis. Patients (n=672) applied a thin layer of 0.1% tacrolimus ointment twice daily for 3 weeks to all affected body areas. After 3 weeks, ointment was applied once daily. Clinical improvement became apparent after 2 weeks of treatment and 65.5% of patients had a rating of clearance, excellent or marked improvement by month 3. Skin burning (31.7%) was the most common causally-related adverse event, followed by pruritus (11.3%) folliculitis (6.4%), alcohol intolerance (5.7%), herpes simplex (5.7%), skin infection (4.6%), skin erythema (3.3%) and hyperaesthesia (2.4%). The most commonly reported infections were flu syndrome (12.9%), skin infection (9.8%), folliculitis (7.4%) and herpes simplex (7.0%). Long-term treatment up to 24 months with 0.1% tacrolimus ointment is safe and efficacious in adults with atopic dermatitis.
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PMID:Long-term treatment with 0.1% tacrolimus ointment in adults with atopic dermatitis: results of a two-year, multicentre, non-comparative study. 1772 47

A 23-year-old woman presented to our polyclinic complaining of itching, generalized dermatitis, and jaundice. She was in her 31st gestational week and had developed pruritus and the dermatitis since the first month of pregnancy; her jaundice started about a month before presentation. Her history included similar complaints in a previous pregnancy, which resulted in premature birth of a baby with a permanent brain defect. One of her sisters had had jaundice and itching in her 27th gestational week and delivered a healthy baby; a second sister had experienced itching and dermatitis in her second trimester and delivered a healthy baby. Physical examination of the patient showed that her eyes were jaundiced (Figure 1); skin examination revealed generalized erythematous excoriated papules, symmetrically distributed all over her body (Figure 2 Figure 3). Laboratory analyses revealed the following results: leukocyte count, 14.30/mm(3) (3.8-10.3/mm(3)); erythrocyte sedimentation rate, 25 mm/h (<20 mm/h); aspartate aminotransferase, 44 U/L (5-40 U/L); alanine aminotransferase, 63 U/L (5-40 U/L); lactate dehydrogenase, 1158 U/L (220-450 U/L); total bilirubin, 6.88 mg/dL (<1.10 mg/dL); and direct bilirubin, 3.27 mg/dL (<0.35 mg/dL). Urinalysis results were positive for bilirubin and urobilinogen. Positive serologic findings included rubella immunoglobulin G, 93 AU/mL (<15) and cytomegalovirus, 188 AU/mL (<10); negative findings included herpes simplex virus type 2 and hepatitis. Histopathologic examination of material collected from the left breast via punch biopsy showed parakeratosis, acanthosis, and perivascular lymphocyte infiltration in dermal vessels. Treatment with 2 g/d cholestyramine and a topical corticosteroid was effective in the patient, who was diagnosed with intrahepatic cholestasis of pregnancy and prurigo of pregnancy based on the clinical, histopathologic, and laboratory findings. To the authors' knowledge, this is the first such reported case in the literature.
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PMID:Intrahepatic cholestasis occurring with prurigo of pregnancy. 1797 52

A 30-year-old man diagnosed with human immunodeficiency virus (HIV) infection 10 years earlier, presented with large tense blisters associated with minimal itching of 10 days' duration. He had no history of oral or genital erosions or ulcerations and showed no symptoms of HIV-related illnesses. Highly active antiretroviral therapy (HAART) had been started 6 weeks earlier when his CD4 count was 116/mL. He initially received nevirapine 200 mg once daily; after 2 weeks with no skin eruptions or other adverse reactions, the dose was increased to 200 mg twice daily. Other components of his HAART included lamivudine and stavudine. The patient was not taking any other prescription or alternative medicines. During the past year, he experienced 4 episodes of intensely itchy urticarial lesions that subsided with antihistamines. The present episode of bullous lesions was also preceded by urticarial lesions. On examination, he had multiple, large, tense bullae over relatively normal-looking skin involving all parts of the body (Figure 1). There were a few well-defined erosions. Nikolsky and bullae spread signs were negative, and no oral or genital erosions or ulcerations were noted. Results of a complete blood count, renal and liver function tests, and chest x-ray were within normal limits. Skin biopsy from one of the blisters showed a subepidermal bulla filled with eosinophils and polymorphonuclear leukocytes (Figure 2). The underlying dermis showed perivascular inflammatory infiltrate composed of polymorphonuclear and lymphomononuclear cells. The overall features were suggestive of bullous pemphigoid. A direct immunofluorescence test could not be done because of possible risk of cross-infection to the operator of the cryostat. Workup for herpes simplex virus and cytomegalovirus infection also could not be performed. HAART was discontinued temporarily with the suspicion that it was the causative factor. The patient was started on oral prednisolone 40 mg/d and topical clobetasol propionate (0.05%). Within 1 week of treatment, he had significant improvement with almost complete disappearance of the lesions. A few small, tense vesicles continued to appear between. Once the lesions completely disappeared, the prednisolone was gradually tapered off and all the components of HAART were resumed. The patient did well without any recurrence of lesions, thus virtually excluding HAART as the cause of the bullous pemphigoid-like eruptions. Subsequently, he did not return for follow-up.
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PMID:Bullous eruption in a patient infected with the human immunodeficiency virus. 1832 12

Alpha-herpesviruses, including human herpes simplex virus 1 & 2, varicella zoster virus and the swine pseudorabies virus (PRV), infect the peripheral nervous system of their hosts. Symptoms of infection often include itching, numbness, or pain indicative of altered neurological function. To determine if there is an in vitro electrophysiological correlate to these characteristic in vivo symptoms, we infected cultured rat sympathetic neurons with well-characterized strains of PRV known to produce virulent or attenuated symptoms in animals. Whole-cell patch clamp recordings were made at various times after infection. By 8 hours of infection with virulent PRV, action potential (AP) firing rates increased substantially and were accompanied by hyperpolarized resting membrane potentials and spikelet-like events. Coincident with the increase in AP firing rate, adjacent neurons exhibited coupled firing events, first with AP-spikelets and later with near identical resting membrane potentials and AP firing. Small fusion pores between adjacent cell bodies formed early after infection as demonstrated by transfer of the low molecular weight dye, Lucifer Yellow. Later, larger pores formed as demonstrated by transfer of high molecular weight Texas red-dextran conjugates between infected cells. Further evidence for viral-induced fusion pores was obtained by infecting neurons with a viral mutant defective for glycoprotein B, a component of the viral membrane fusion complex. These infected neurons were essentially identical to mock infected neurons: no increased AP firing, no spikelet-like events, and no electrical or dye transfer. Infection with PRV Bartha, an attenuated circuit-tracing strain delayed, but did not eliminate the increased neuronal activity and coupling events. We suggest that formation of fusion pores between infected neurons results in electrical coupling and elevated firing rates, and that these processes may contribute to the altered neural function seen in PRV-infected animals.
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PMID:Pseudorabies virus infection alters neuronal activity and connectivity in vitro. 1987 91

An 11-year-old boy presented with inability to move his right arm, back and neck pain, and fever. He had a history of recurrent vesicular rash on his face three times over the past two years. Magnetic resonance imaging (MRI) showed diffuse expansile cervical cord, leading to a diagnosis of transverse myelitis. After 3 days of intravenous solumedrol, the patient was discharged, but returned the following day with a vesicular rash to the right arm, as well as vomiting, malaise and diffuse pruritus.Wright-Giemsa stain of the vesicles revealed herpes group virus and culture was positive for herpes simplex type 1.
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PMID:A boy unable to move his arm. 2016 75


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