HERPETIC WHITLOW |
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DESCRIPTIONHerpetic whitlow is an inflammation of skin folds around the fingernails caused by a contagious herpes virus. Fingernails or toenail beds are involved. Herpetic whitlow is more common in adults than children.
Appropriate health care includes:
Self-care after diagnosis.
Physician's monitoring of general condition, medications, and treatment, which may include minor surgery to relieve pressure of pus pockets under the skin.
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 FACTORS
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.
PREVENTING COMPLICATIONS OR RECURRENCE
Your child should avoid exposure to people who have active herpes infections.
Your child should keep hands warm and dry.
BASIC INFORMATION
MEDICAL TESTS
Your own observation of symptoms.
Medical history and physical exam by a doctor.
Laboratory culture of discharge from the infected area.
POSSIBLE COMPLICATIONSSpread 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.
TREATMENT
HOME CARE
Encourage your child to protect hands to prevent further injury or spread of the infection to others. The child should 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.
Urge your child not to touch other persons until inflammation clears.
MEDICATION
Your doctor may prescribe:
Topical steroid preparations to reduce inflammation. They include creams, ointments, and lotions. Your child should apply the topical steroid only once or twice a day unless directed otherwise. Apply it immediately after bathing to aid penetration.
Oral anti-viral medications (not always effective, but safe enough for a trial in severe cases that do not respond to traditional treatment).
See Medications section for information regarding medicines your doctor may prescribe.
ACTIVITY
No restrictions.
DIET & FLUIDS
No special diet.
OK TO GO TO SCHOOL?When appetite has returned and alertness, strength, and feeling of well-being will allow.
CALL YOUR DOCTOR IF
Your child has 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 child's body.
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