Herpetic whitlow: Difference between revisions
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*Vesicular ullae | *Vesicular ullae | ||
*Finger may be indurated and tender (but should not be tense, as in a felon) | *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== | ==Diagnosis== | ||
Revision as of 22:03, 25 August 2014
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
- Bed bugs
- Closed fist infection (Fight Bite)
- Hand cellulitis
- Hand deep space infection
- Hand-foot-and-mouth disease
- Herpetic whitlow
- Felon
- Flexor tenosynovitis
- Paronychia
- Scabies
- Sporotrichosis
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