Categories
Internal Medicine

Herpetic whitlow

Herpetic whitlow results from autoinoculation of type 1 or type 2 herpes simplex virus into broken skin and may occur as a complication of primary oral or genital herpes lesions.

Herpetic whitlow results from autoinoculation of type 1 or type 2 herpes simplex virus into broken skin and may occur as a complication of primary oral or genital herpes lesions.


Clinical findings

Self-limited and resolves in two to three weeks

  • Abrupt onset of edema, erythema, and significant localized tenderness of the infected finger (pain is out of proportion to the physical findings)
  • Fever, lymphadenitis, and epitrochlear and axillary lymphadenopathy
  • Initially,
    • Small, clear vesicles present
385px-infection_of_the_pulp_space_of_the_thumb

Diagnosis

  • Tzanck test
    • Scraping of an ulcer base to look for Tzanck cells
  • Viral culture
  • DNA amplification technique

Management

  • Within first 48 hours of symptom onset:
    • Acyclovir (Zovirax)
    • Famciclovir (Famvir)
    • Valacyclovir (Valtrex) 
  • Prevent incision and drainage
    • May cause viremia or bacterial infection

Leave a Reply