HERPETIC WHITLOW

General Information

DEFINITION--An inflammation of skin folds around the fingernails caused by a contagious herpes virus.

BODY PARTS INVOLVED--Fingernail or toenail bed.

SEX OR AGE MOST AFFECTED--All ages, but most common in adults.

SIGNS & SYMPTOMS

• Sudden pain around the nail.
• Redness, swelling and warmth around the nail.
• Swelling of the lymph glands nearby, such as in the elbow or armpit.
• Groupings of tiny blisters that are barely visible around the nail.

CAUSES--Herpes virus hominus, Type 1 or Type 2. Herpetic whitlow is often transmitted to the fingers from cold sores (herpes simplex) on the mouth.

RISK INCREASES WITH

• Occupational exposure to constant wetness, such as with dishwashers or maintenance personnel.
• Occupational exposure to herpes infection, such as with nurses, dentists or dental assistants who provide mouth care.

HOW TO PREVENT

• Avoid exposure to people who have active herpes infections.
• Keep hands warm and dry.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory culture of discharge from the infected area.

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Doctor's treatment.

POSSIBLE COMPLICATIONS--Spread of herpes infection to other body parts, such as the lips or genitals.

PROBABLE OUTCOME--The first episode is usually curable in 2 months with treatment. However, recurrent attacks are common.

How To Treat

GENERAL MEASURES--

• Protect your hands to prevent further injury or spread of the infection to others. Wear heavy-duty vinyl gloves to avoid contact with irritating substances, such as water, soap, detergent, metal scrubbing pads, scouring pads, scouring powder and other chemicals.
• Don't touch other persons until inflammation clears.

MEDICATION--Your doctor may prescribe:

• Topical steroid preparations to reduce inflammation. They include creams, ointments and lotions. Apply the topical steroid only once or twice a day unless directed otherwise. Apply immediately after bathing for better spreading and penetration.
• Oral antiviral medications.

ACTIVITY--No restrictions.

DIET--No special diet.

Call Your Doctor If

• You have symptoms of herpetic whitlow.
• Temperature rises over 101F (38.3C).
• Symptoms don't improve in 3 days, despite treatment.
• Herpes lesions appear elsewhere on the body.