Viruses – Herpetic Whitlow

Herpetic Whitlow occurs when Herpes Simplex Virus (HSV) Type 1 or 2 infects the fingers, which I encounter in my The Woodlands dermatology and Conroe dermatology offices.  Most cases in children are caused by HSV-1 but the majority of adult cases are due to HSV-2 and is most common in women.  Dentists and dental hygienists are the most commonly affected healthcare workers with Herpetic Whitlow as holes in latex gloves can lead to exposure of the skin to HSV in a patient’s oral mucosa.  Children are usually exposed by touching the mouth of an infected adult or sucking their own fingers if they have orolabial herpes.  The intial eruption in Herpetic Whitlow begins as pain and erythema on the fingertip or lateral nailfold followed by deep seated blisters that may appear to be a bacterial abscess.  The stratum corneum of the fingers is so thick that the blisters may not be apparent.  The entire hand can swell and lymphatic streaking and lymphadenopathy are very common.  Treatment is with Valacyclovir and it is very important that patients with Herpetic Whitlow understand that they are contagious as the herpes infections on the hands are easily transferred to others.