Herpetic whitlow
Encyclopedia
A herpetic whitlow is a lesion (whitlow
) on a finger or thumb caused by the herpes simplex virus
. It is a painful infection that typically affects the fingers or thumbs. Occasionally infection occurs on the toes or on the nail cuticle. Herpes whitlow
can be caused by infection by HSV-1 or HSV-2. HSV-1 whitlow is often contracted by health care workers that come in contact with the virus; it is most commonly contracted by dental workers and medical workers exposed to oral secretions. It is also often observed in thumb-sucking children with primary HSV-1 oral infection (autoinoculation
) prior to seroconversion
, and in adults aged 20 to 30 following contact with HSV-2-infected genitals. Symptoms of herpetic whitlow include swelling, reddening and tenderness of the skin of infected finger. This may be accompanied by fever and swollen lymph nodes. Small, clear vesicles initially form individually, then merge and become cloudy. Associated pain often seems large relative to the physical symptoms. The herpes whitlow lesion usually heals in two to three weeks.
(in this case commonly HSV-1) is transferred by the chewing or sucking of fingers or thumbs.
In adults it is more common for the primary source to be the genital region, with a corresponding preponderance of HSV-2. It is also seen in adult health care workers such as dentist
s because of increased exposure to the herpes virus.
treatments applied to the infected skin, particularly topical acyclovir, have been shown to be effective in decreasing the duration of symptoms. Lancing
or surgically debriding the lesion
may make it worse by causing a superinfection
or encephalitis
.
Whitlow
A whitlow or felon is an infection of the tip of the finger. The terms are also sometimes misapplied to paronychia, which is an infection of the tissue at the side or base of the nail....
) on a finger or thumb caused by the herpes simplex virus
Herpes simplex virus
Herpes simplex virus 1 and 2 , also known as Human herpes virus 1 and 2 , are two members of the herpes virus family, Herpesviridae, that infect humans. Both HSV-1 and HSV-2 are ubiquitous and contagious...
. It is a painful infection that typically affects the fingers or thumbs. Occasionally infection occurs on the toes or on the nail cuticle. Herpes whitlow
Whitlow
A whitlow or felon is an infection of the tip of the finger. The terms are also sometimes misapplied to paronychia, which is an infection of the tissue at the side or base of the nail....
can be caused by infection by HSV-1 or HSV-2. HSV-1 whitlow is often contracted by health care workers that come in contact with the virus; it is most commonly contracted by dental workers and medical workers exposed to oral secretions. It is also often observed in thumb-sucking children with primary HSV-1 oral infection (autoinoculation
Autoinoculation
Autoinoculation is derived from the Latin root words "autos" and "inoculate" that mean "self implanting" or "self infection" or "implanting something from oneself". Autoinoculation can refer to both beneficial medical procedures as well as non-beneficial or harmful natural processes...
) prior to seroconversion
Seroconversion
Seroconversion is the development of detectable specific antibodies to microorganisms in the blood serum as a result of infection or immunization. Serology is used to determine antibody positivity...
, and in adults aged 20 to 30 following contact with HSV-2-infected genitals. Symptoms of herpetic whitlow include swelling, reddening and tenderness of the skin of infected finger. This may be accompanied by fever and swollen lymph nodes. Small, clear vesicles initially form individually, then merge and become cloudy. Associated pain often seems large relative to the physical symptoms. The herpes whitlow lesion usually heals in two to three weeks.
Causes
In children the primary source of infection is the orofacial area, and it is commonly inferred that the virusVirus
A virus is a small infectious agent that can replicate only inside the living cells of organisms. Viruses infect all types of organisms, from animals and plants to bacteria and archaea...
(in this case commonly HSV-1) is transferred by the chewing or sucking of fingers or thumbs.
In adults it is more common for the primary source to be the genital region, with a corresponding preponderance of HSV-2. It is also seen in adult health care workers such as dentist
Dentist
A dentist, also known as a 'dental surgeon', is a doctor that specializes in the diagnosis, prevention, and treatment of diseases and conditions of the oral cavity. The dentist's supporting team aides in providing oral health services...
s because of increased exposure to the herpes virus.
Treatment
Although it is a self-limited illness, antiviralAntiviral drug
Antiviral drugs are a class of medication used specifically for treating viral infections. Like antibiotics for bacteria, specific antivirals are used for specific viruses...
treatments applied to the infected skin, particularly topical acyclovir, have been shown to be effective in decreasing the duration of symptoms. Lancing
Incision and drainage
Incision and drainage and clinical lancing are minor surgical procedures to release pus or pressure built up under the skin, such as from an abscess, boil, or infected paranasal sinus...
or surgically debriding the lesion
Lesion
A lesion is any abnormality in the tissue of an organism , usually caused by disease or trauma. Lesion is derived from the Latin word laesio which means injury.- Types :...
may make it worse by causing a superinfection
Superinfection
In virology, superinfection is the process by which a cell, that has previously been infected by one virus, gets coinfected with a different strain of the virus, or another virus at a later point in time. Viral superinfections of serious conditions can lead to resistant strains of the virus, which...
or encephalitis
Encephalitis
Encephalitis is an acute inflammation of the brain. Encephalitis with meningitis is known as meningoencephalitis. Symptoms include headache, fever, confusion, drowsiness, and fatigue...
.