Skin & Soft Tissue: Herpetic Whitlow

Definition

• Definition: Viral Infection of the Hand from Herpes Simplex Virus (HSV-1 & HSV-2)
• From Direct Contact with Oral/Genital Secretions of HSV-Infected Patients
  • May be Seen in Healthcare Workers if Not Using Universal Precautions

Presentation

• Clear-Yellow Erythematous Vesicles of the Hands
  • Pulp Space is Not Tense (Compared to Felon)
• Pain Out of Proportion
• May Be Single or Clustered
• May Mimic Paronychia or Felon

Treatment

• Primary Treatment: Conservative Management (Rest & Anti-inflammatory Agents)
  • May Consider Antivirals (Acyclovir, Famciclovir or Valacyclovir)
  • Antibiotics Only Indicated for Secondary Bacterial Infections
• Generally Resolves within 2-3 Weeks
• 30-50% Recur Although Initial Infection is Usually the Worst