Herpes simplex virus (HSV) is widespread and typically spreads as a result direct physical contact during childhood. The most prevalent sites of infection are oral mucosa (HSV-1) and vaginal mucosa (HSV-2).
Rarely, the infection can be transmitted to the distal phalanx through direct injection, resulting in discomfort, swelling, erythema, and vesicles, a condition known as herpetic whitlow.
Given its similar appearance to paronychia and its drastically different treatment, this diagnosis is of particular importance.
Epidemiology
This infection can affect individuals of any age. However, it is particularly prevalent among children who habitually suck their thumbs and also in medical and dental professionals who are exposed to oral mucosa without wearing gloves.
The prevalence of the infection is highest among respiratory therapists and dental hygienists.
This disease has also been observed in wrestlers, teenagers, and young adults who have been exposed to genital herpes. The annual incidence has been estimated at 2.4 cases per 100,000 individuals.
Anatomy
Pathophysiology
After exposure, herpes virus types 1 and 2 cause viral invasion and replication in epidermal and dermal cells. Eventually, this may affect the sensory dorsal root ganglion, which establishes latencies for sensory input. Infection often arises between 2 and 20 days after exposure.
In 5 to 6 days, one or more vesicles typically merge into enormous, honeycomb-like bullae around the nail. They may also spread proximally and affect the nail bed. The infection typically cures on its own within two to four weeks.
Etiology
Herpes simplex virus types 1 and 2 cause herpetic whitlow. Exogenous or autogenous inoculations via broken skin are the primary causes of infection. Following primary infection, a patient may get herpetic whitlow due to reactivation of latent virus.
Genetics
Prognostic Factors
Herpetic whitlow is often self-limiting and typically disappears within two to four weeks in cases of original infection. The pain subsides after the acute phase, but the vesicles start to dry and harden. The pain often subsides after 2 weeks, and other changes in the skincontinue to mend thereafter.
There have been instances of persistent scarring, numbness, and hypersensitivity, although fingers and toenails normally heal without further complications. Latent sensory ganglion infection has caused recurrent outbreaks in 30% to 50% of cases.
Clinical History
Physical Examination
Age group
Associated comorbidity
Associated activity
Acuity of presentation
Differential Diagnoses
Laboratory Studies
Imaging Studies
Procedures
Histologic Findings
Staging
Treatment Paradigm
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by Modality
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Radiation Therapy
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Hormone Therapy
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Future Trends
Media Gallary
References
https://www.ncbi.nlm.nih.gov/books/NBK482379/
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Herpes simplex virus (HSV) is widespread and typically spreads as a result direct physical contact during childhood. The most prevalent sites of infection are oral mucosa (HSV-1) and vaginal mucosa (HSV-2).
Rarely, the infection can be transmitted to the distal phalanx through direct injection, resulting in discomfort, swelling, erythema, and vesicles, a condition known as herpetic whitlow.
Given its similar appearance to paronychia and its drastically different treatment, this diagnosis is of particular importance.
This infection can affect individuals of any age. However, it is particularly prevalent among children who habitually suck their thumbs and also in medical and dental professionals who are exposed to oral mucosa without wearing gloves.
The prevalence of the infection is highest among respiratory therapists and dental hygienists.
This disease has also been observed in wrestlers, teenagers, and young adults who have been exposed to genital herpes. The annual incidence has been estimated at 2.4 cases per 100,000 individuals.
After exposure, herpes virus types 1 and 2 cause viral invasion and replication in epidermal and dermal cells. Eventually, this may affect the sensory dorsal root ganglion, which establishes latencies for sensory input. Infection often arises between 2 and 20 days after exposure.
In 5 to 6 days, one or more vesicles typically merge into enormous, honeycomb-like bullae around the nail. They may also spread proximally and affect the nail bed. The infection typically cures on its own within two to four weeks.
Herpes simplex virus types 1 and 2 cause herpetic whitlow. Exogenous or autogenous inoculations via broken skin are the primary causes of infection. Following primary infection, a patient may get herpetic whitlow due to reactivation of latent virus.
Herpetic whitlow is often self-limiting and typically disappears within two to four weeks in cases of original infection. The pain subsides after the acute phase, but the vesicles start to dry and harden. The pain often subsides after 2 weeks, and other changes in the skincontinue to mend thereafter.
There have been instances of persistent scarring, numbness, and hypersensitivity, although fingers and toenails normally heal without further complications. Latent sensory ganglion infection has caused recurrent outbreaks in 30% to 50% of cases.
https://www.ncbi.nlm.nih.gov/books/NBK482379/
medtigo
Herpetic Whitlow
Updated :
September 17, 2022
Herpes simplex virus (HSV) is widespread and typically spreads as a result direct physical contact during childhood. The most prevalent sites of infection are oral mucosa (HSV-1) and vaginal mucosa (HSV-2).
Rarely, the infection can be transmitted to the distal phalanx through direct injection, resulting in discomfort, swelling, erythema, and vesicles, a condition known as herpetic whitlow.
Given its similar appearance to paronychia and its drastically different treatment, this diagnosis is of particular importance.
This infection can affect individuals of any age. However, it is particularly prevalent among children who habitually suck their thumbs and also in medical and dental professionals who are exposed to oral mucosa without wearing gloves.
The prevalence of the infection is highest among respiratory therapists and dental hygienists.
This disease has also been observed in wrestlers, teenagers, and young adults who have been exposed to genital herpes. The annual incidence has been estimated at 2.4 cases per 100,000 individuals.
After exposure, herpes virus types 1 and 2 cause viral invasion and replication in epidermal and dermal cells. Eventually, this may affect the sensory dorsal root ganglion, which establishes latencies for sensory input. Infection often arises between 2 and 20 days after exposure.
In 5 to 6 days, one or more vesicles typically merge into enormous, honeycomb-like bullae around the nail. They may also spread proximally and affect the nail bed. The infection typically cures on its own within two to four weeks.
Herpes simplex virus types 1 and 2 cause herpetic whitlow. Exogenous or autogenous inoculations via broken skin are the primary causes of infection. Following primary infection, a patient may get herpetic whitlow due to reactivation of latent virus.
Herpetic whitlow is often self-limiting and typically disappears within two to four weeks in cases of original infection. The pain subsides after the acute phase, but the vesicles start to dry and harden. The pain often subsides after 2 weeks, and other changes in the skincontinue to mend thereafter.
There have been instances of persistent scarring, numbness, and hypersensitivity, although fingers and toenails normally heal without further complications. Latent sensory ganglion infection has caused recurrent outbreaks in 30% to 50% of cases.
https://www.ncbi.nlm.nih.gov/books/NBK482379/
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