Herpetic whitlow is a viral infection of the hands or fingers resulting from contact with an individual experiencing a herpes simplex virus 1 (which results in oral herpes) or herpes simplex 2 (which results in genital herpes) outbreak. Two-and-a-half to five individuals per 100,000 are affected each year. Children are most commonly infected with herpes whitlow, however health-care providers and dentists are also commonly infected. Herpes simplex 1 accounts for 60% of the cases in a given year, while herpes simplex 2 accounts for 40%.
Herpes whitlow occurs when an individual touches their own lesions or from touching another’s lesions. It is not uncommon for children to develop this viral infection as a result of sucking their thumb or fingers during an outbreak.
Herpes whitlow presents itself as several small, red, swollen, fluid-filled blisters on a finger, fingers, or hand. The individual may also have a fever, swollen lymph nodes, and red streaks radiating from the blisters.
In herpetic whitlow, it’s possible for the infection to spread to other fingers, or to your eyes if you touch or rub them with your infected finger.
If you have a weakened immune system, the herpetic whitlow infection can be severe and cause serious complications such as pneumonia or encephalitis (inflammation of your brain). It’s therefore important to seek urgent medical advice if your immune system is weakened and you have symptoms of herpetic whitlow.
Treatment usually involves easing the discomfort resulting from the lesions, shortening the outbreak period, and preventing future outbreaks. Outbreaks can last from one to three weeks, but usually last 7 to 10 days. During an outbreak, the individual can take over-the-counter pain relievers such as aspirin, or ibuprofen (Advil or Motrin). Children should only be given Tylenol, because aspirin can result in the child developing Reye’s syndrome. Cold compresses are also helpful in reducing pain.
A doctor may prescribe antiviral pills such as Acyclovir, Valacyclovir, or Famciclovir. Topical Acyclovir ointment can also be used to shorten the period of outbreak, and to reduce the chance of spreading the virus.
During an outbreak, the infected individual should not share personal items such as towels, toothbrushes, makeup or eating utensils. He should wash his hands regularly and avoid transmitting the virus via person-to-person contact. It is essential that he not pick, pop, rub or scratch the lesions, but allow them to heal. A bandage should be worn to protect the lesions and prevent infecting others. Health-care providers and dentists should always wear protective gloves to prevent the transmission of herpetic whitlow, either from others to themselves or from themselves to others.
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