Herpetic whitlow

Revision as of 22:03, 25 August 2014 by Kxl328 (talk | contribs)

Background

  • HSV infection of distal finger
    • Usually occurs from contact w/ oral herpes, or autoinoculation from genital herpes
    • Incubation period of 2-20 days, with possible prodrome of fever or malaise
    • 60% due to HSV-1, 40% due to HSV-2

Clinical Features

  • Same burning, pruritic sensation as from other herpes infections
  • Vesicular ullae
  • Finger may be indurated and tender (but should not be tense, as in a felon)
  • Rash develops over 7-10 days, with possible ulceration and rupture
  • Symptoms improve, crust over, and heal after 10-14 days with viral shedding terminating at this point
  • Complete resolution by 15-21 days

Diagnosis

  • If unsure of diagnosis can unroof a vesicle and send fluid for a Tzanck smear

Differential Diagnosis

Hand and finger infections

Look-Alikes

Treatment

  • Immobilization, elevation, analgesia
  • Acyclovir/valacyclovir may shorten duration of infection
  • Prevent autoinoculation or spread to other individuals by applying clean dressing

See Also

Source

  • Tintinalli