Topical glycopirrolate for the management of hyperhidrosis in herpetic neuralgia

Herpes zoster is a relapse of varicella. In certain cases, long-term pain and hyperhidrosis have been noted. Appearance of herpes zoster during pregnancy is infrequent. We described hyperhidrosis and pain treatment using glycopirrolate cream in a pregnant woman with herpetic neuralgia. A 32 year old...

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Bibliographic Details
Published in:Yonsei medical journal 2009, 50(2), , pp.293-295
Main Authors: Ladjevic, Nebojsa Gojko, Likic-Ladjevic, Ivana Spasoje
Format: Article
Language:English
Subjects:
Adjuvants, Anesthesia - administration & dosage
Adjuvants, Anesthesia - therapeutic use
Administration, Topical
Adult
Case Report
Female
Glycopyrrolate - administration & dosage
Glycopyrrolate - therapeutic use
Herpes Zoster - drug therapy
Herpes Zoster - pathology
Humans
Neuralgia - pathology
Neuralgia - physiopathology
Pregnancy
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Summary:Herpes zoster is a relapse of varicella. In certain cases, long-term pain and hyperhidrosis have been noted. Appearance of herpes zoster during pregnancy is infrequent. We described hyperhidrosis and pain treatment using glycopirrolate cream in a pregnant woman with herpetic neuralgia. A 32 year old woman, 21 weeks pregnant with second child, complained to her gynecologist of the appearance of a vesicular rash on the left half of the forehead that progressed toward her left eyelid, accompanied by lancinating pain, allodynia, hyperhidrosis and small edema, blepharitis and conjunctivitis. Following clinical and laboratory tests, she was diagnosed with herpes zoster ophtalmicus. Aciclovir therapy was administered 800 mg orally five times daily for seven days. Pain therapy was initiated with amitriptilline. We discontinued amitriptilline therapy after 10 days because of appearance of unwanted side effects. After skin changes ceased, we introduced Lidocaine patch into pain therapy which reduced the allodynia, but not the lancinating pain and hyperhidrosis. At that time we began using glycopirrolate cream which reduced pain intensity by 28.5% within 24 hours, and completely eliminated hyperhidrosis. After 48 hours of use, the pain completely disappeared. During the Glycopirrolate cream therapy, there were no side effects. This is a first report to document that a topical Glycopirrolate cream has a beneficial effect in a patient with hyperhidrosis and herpetic neuralgia.
ISSN:0513-5796
1976-2437
DOI:10.3349/ymj.2009.50.2.293