Last reviewed by Dr. Raj MD on January 12th, 2022.
Herpetic Whitlow is a fingertip infection that is intensely painful and involves one or even more fingers and normally involves the terminal phalanx. Herpetic whitlow causes blister and pain that is intense. Symptoms normally resolve in two weeks. With children as well as approximately 60% of all cases develop because of herpes simplex virus 1 or HSV-1. In adults as well as 40% of all cases develop due to herpes simplex virus type 2 which also is the cause of genital herpes.
This infection was first described in the year 1909 and fifty years later was designated to be an occupational hazard among workers in the healthcare field.
Herpetic Whitlow Symptoms
Signs and symptoms of this disorder include:
This is the first symptom that occurs with this disease. The condition begins with swelling on the finger that causes mild to severe pain.
Area that is affected normally is red and swollen.
The area of the thumb or fingers will usually develop lesions.
Skin of affected area becomes tender and causes severe pain. Some individuals can also experience a tingling and burning sensation. Those suffering with this disease will find it extremely hard to perform normal daily activities.
Swelling of lymph nodes
Some individuals may suffer as well from painful and swollen lymph nodes located under their arms.
Cases of this disease that are severe can result in high grade fever. But these cases are extremely rare.
Herpetic Whitlow Causes
This infection is mainly caused by an infection with HSV 1 or HSV 2. These are viruses that mainly are found in genital or oral secretions. Workers in healthcare as well as dental workers are exposed constantly to this virus and can suffer from this disease or infection. Individuals with immunity that is low are at risk from this disorder. In those who are HIV patients are susceptible in high percentages.
In those cases of this infection in a child, the signs and symptoms usually develop in children who have mouth herpes symptoms. These children get this infection from sucking the thumb or other fingers. This is when virus from the lips or mouth may then be able to enter through cuts or breaks in the skin of the fingers. This is called “auto inoculation” which also may occur in healthcare workers and dentists who are quite prone to come in contact with individuals who have the virus. Others are mainly thought to be infected by contact with individuals having genital herpes.
In other words, this infection may be contracted by skin to skin contact with a person who is affected or from an infected part of the body of that same individual. When an individual is exposed, symptoms usually develop in two to twenty days. The individual will have a tingling or burning sensation in the finger together with pain. After about 10 to 12 days, the finger will become inflamed, red and tender. Tiny blisters will develop on the finger. The blisters normally are found to develop in clusters forming a red base. These blisters do heal by themselves usually within 2 weeks. Some individuals might also develop some added symptoms such as fever or swollen lymph nodes under the arm.
Most of all, the individuals will have intense pain caused by the lesions. Once the symptoms are gone, the virus remains but is inactive. The infection developing again is not that common but there are some cases where the virus is triggered by other factors and causes a renewed infection.
Herpetic Whitlow Treatment
Most infections by herpes simplex are quite easy for your physician to diagnose. But there are occasions, where a swab from the skin that is infected might need to be tested in the lab by viral culture that takes several days to grow. Tests of the blood might also be taken.
These infections when left untreated normally go away on their own, but drugs can lessen the symptoms as well as shorten the duration of any outbreaks. There is no cure for infections from herpes simplex virus.
Even though herpetic whitlow symptoms eventually leave on their own, your primary care physician usually advises prescription medications known as antivirals to help with symptom relief and to stop any infection from spreading to other individuals. These include: valacyclovir pills, acyclovir pills, famciclovir pills and topical acyclovir ointment. These drugs normally take seven to fourteen days.
When this infection is more severe it may need oral antibiotic pills especially of the area is also infected by a bacterium.
Though rare, this infection can return and may be treated with the same oral antiviral drugs.
Individuals who have early signs or prodromes prior to infections recurring might benefit from treatment episodically by starting medication after the onset of burning and tingling before the appearance of any sores or blisters. Other rare complications can be recurrent outbreaks which are so very frequent or severe enough to call for suppression therapy, where medications are given every day so as to decrease the severity or frequency of attacks.
Is Herpetic Whitlow Contagious?
Any infection with HSV is quite contagious and is spread easily by making contact with skin lesions that are infected. HSV infections normally appear as tiny sores or blisters around the nose, mouth, buttocks as well as genitals, though these infections may develop almost any place on skin. These tender sores also can recur from time to time in the exact same areas.
Herpetic Whitlow Pictures
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