Materiały źródłowe

• #1 Herpetic whitlow. Epidemiology, clinical characteristics, diagnosis, and treatment – PubMed

  https://pubmed.ncbi.nlm.nih.gov/6613951/

  Herpetic whitlow is a herpes simplex virus infection of a distal phalanx. It is characterized by pain, swelling, erythema, and nonpurulent vesicle formation. Herpetic whitlow follows direct inoculation (exogenous or autogenous) or reactivation of latent virus. In children, it most frequently occurs following a primary oral herpes infection. In adolescents, herpetic whitlow is commonly associated with genital herpes infections. In adults, it frequently occurs in medical personnel who have contact with patients’ oral secretions or is associated with genital herpes infections. […] The diagnosis of herpetic whitlow is readily confirmed by Tzanck test and culture. It is important to distinguish herpetic whitlow from bacterial felon or paronychia, as herpetic whitlow is a self-limited infection for which surgical incision is not indicated.

• #2 Herpetic Whitlow – Presentation and Management

  https://pedemmorsels.com/herpetic-whitlow-dont-cut-it/

  Due to HSV infection of the distal phalanx. […] Is actually a misnomer: Whitlow refers to a painful, pus-producing infection of the deep space of the finger. Herpetic Whitlows do not have purulence, so not really a whitlow but lets not quibble over semantics. […] Often associated with: In children primary gingivostoatitis and autoinoculation, or trauma […] In Adolescents/Adults may be associated with genital HSV infections […] In Adults often are medical professionals who get inoculated by patients (so wear gloves! […] Herpetic Whitlow usually will not have tense pulp space like Felon. […] Serous drainage rather than purulence. […] Feder HM, Long SS. Herpetic Whitlow: Epidemiology, Clinical Characteristics, Diagnosis, and Treatment. Am J Dis Child. Sept 1983; 137: 861-863.

• #3 Herpetic Whitlow – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK482379/

  Herpetic whitlow is caused by the herpes simplex virus, type 1 or type 2. […] This infection can be found in any age group. However, it is most common in children who suck their thumbs and in healthcare providers (medical or dental) who are exposed to patients oral mucosa while not wearing gloves. […] Its incidence has been reported at 2.4 cases per 100,000 people per year.

• #4 Herpetic Whitlow: Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/788056-overview

  Herpetic whitlow is an intensely painful infection of the hand involving 1 or more fingers that typically affects the terminal phalanx. Herpes simplex virus 1 (HSV-1) is the cause in approximately 60% of cases of herpetic whitlow, and herpes simplex virus 2 (HSV-2) is the cause in the remaining 40%. […] In 1959, it was noted to be an occupational risk among healthcare workers. […] Annual incidence is estimated at 2.4-5.0 cases per 100,000 population. […] Mortality related to herpetic whitlow can be presumed to be negligible. […] Morbidity is related primarily to bacterial superinfection or to iatrogenic complications due to a misguided incision and drainage resulting from incorrect diagnosis of the infection as a bacterial paronychia. […] Males and females are affected equally by herpetic whitlow. […] Toddlers and preschool children are most likely to engage in thumb-sucking or finger-sucking behavior; therefore, they are susceptible to herpetic whitlow if they have herpes labialis or herpetic gingivostomatitis.

• #5 Herpetic Whitlow — DermNet

  https://dermnetnz.org/topics/herpetic-whitlow

  One case series reported the incidence of herpetic whitlow as 2.4 cases per 100,000 people per year. Males and females appear to be equally affected. […] Herpetic whitlow in adults is more commonly associated with exposure to genital herpes, or occupational exposure of dental and other health care workers to patients with herpes simplex including oral secretions. […] People who are immunosuppressed are also more susceptible to herpetic infections.

• #6 Herpetic Whitlow | 5-Minute Clinical Consult

  https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/117494/all/Herpetic_Whitlow

  Painful, self-limited, cutaneous viral infection of the finger(s), caused by herpes simplex virus (HSV-1 or HSV-2) (1) […] Usually limited to distal phalanx (2); highly contagious and spread easily via direct contact (1) […] Predominant age: bimodal age distribution: children 10 years of age and adults 20 to 30 years. Among children 10 years, those 2 years make up the majority of cases (2). […] Predominant sex (adults): female male (2.3:1) […] Incidence 2.4 cases per 100,000 in 1 year (2)

• #7 Herpetic whitlow – wikidoc

  https://www.wikidoc.org/index.php/Herpetic_whitlow

  A herpetic whitlow is a lesion on a finger or thumb caused by the herpes simplex virus. In children the primary source of infection is the orofacial area, and it is commonly inferred that the virus (in this case commonly HSV-1) is transferred by the chewing or sucking of fingers or thumbs. In adults it is more common for the primary source to be the genital region, with a corresponding preponderance of HSV-2. It is also seen in adult health care workers such as dentists because increased exposure to the herpes virus. […] It is typically contracted by healthcare workers that come in contact with the virus; it is most commonly contracted by dental workers and medical workers exposed to oral secretions. […] The HSV seronegative person is at highest risk of acquiring this condition. It is often observed in thumb-sucking children with primary HSV-1 infection, and in adults aged 20 to 30 following contact with by HSV-2-infected genitals. […] Herpes whitlows are frequently found among dentists and dental hygienists.

• #8 Herpetic Whitlow: Causes, Symptoms & Treatment

  https://sehathub.com/herpetic-whitlow

  Herpetic whitlow is a painful skin condition characterized by the formation of vesicles and blisters on fingernails. This contagious disease is caused by the herpes simplex virus (HSV) infection. Reports suggest it has a global incidence of 2.4 cases/100,000 people per year. […] Yes, like other herpes infections (genital herpes and cold sores), herpetic whitlow is contagious. You can contract the disease if open skin (cut) or sore on a finger comes in contact with the sore/blister of an infected person. […] Certain individuals and professionals are at greater risk of developing Whitlows finger due to frequent contact of hands/fingers with oral mucosa and genital skin. […] Herpetic whitlow is a viral infection of the fingernail that usually affects those with weak immunity. Caused by the Herpes simplex virus (HSV), whitlow can develop in cold sores (HSV-1) and genital herpes (HSV-2) patients. The virus spreads from the infected skin through a cut/open wound in the finger skin.

• #9 Cukurova Medical Journal » Submission » Herpetic whitlow in a child with onychophagia: a rare form of cutaneous infection.

  https://dergipark.org.tr/en/pub/cumj/issue/38921/413816

  Herpetic whitlow is a kind of finger infection caused by herpes simplex viruses. Herpetic ileus is a skin infection characterized by painful, nonpurulent, and erythematous lesions usually affecting the distal phalanx and rarely seen on the toes. It is especially common in children with finger-sucking and nail-biting habits. […] Physicians should be familiar with the subject for appropriate diagnosis and appropriate treatment. In addition, pediatricians, anesthesiologists, emergency physicians and dentists contact daily oral secretions of patients infected with the herpes simplex virus. For this reason, herpetic whitlow should be kept in mind as a professional risk for health workers. […] Feder HM Jr, Long SS. Herpetic whitlow. epidemiology, clinical characteristics, diagnosis, and treatment. Am J Dis Child. 1983;137:861-3.

• #10 Herpetic Whitlow

  https://www.patientcareonline.com/view/herpetic-whitlow

  Herpetic whitlow is somewhat common in dental and medical personnel, who contract herpes simplex from H hominis found in their patients’ saliva. […] A herpes simplex virus infection must be considered if vesiculation recurs in the same location and prodromal tingling and pain arise at the site.

• #11 Herpetic Whitlow | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/22848

  Herpetic whitlow is caused by the herpes simplex virus, type 1 or type 2. Primary infection is through direct exogenous or autogenous inoculation through broken skin. Recurrent infection may occur when a patient gets herpetic whitlow by reactivation of latent virus months to years following primary infection. […] This infection can be found in any age group. However, it is most common in children who suck their thumbs and in healthcare providers (medical or dental) who are exposed to patients oral mucosa while not wearing gloves. The infection is most common in dental hygienists and respiratory therapists. Herpetic whitlow has also been documented in athletes who wrestle and adolescents and young adults following genital herpes exposure. Its incidence has been reported at 2.4 cases per 100,000 people per year.

• #12

  https://journals.lww.com/nursing/fulltext/2004/07000/getting_the_lowdown_on_herpetic_whitlow.16.aspx

  A PAINFUL, VESICULAR inflammation of the tip of the finger or toe, herpetic whitlow is caused by herpes simplex virus (HSV) type 1 or 2. The condition develops when oral secretions or mucous membranes infected with HSV come in contact with a cutaneous break, such as an abrasion or torn cuticle. Health care workers, especially nurses and respiratory and anesthesiology staff, are particularly susceptible because of their hands-on contact with patients who may be infected. […] The health care provider will base her diagnosis on signs and symptoms and confirm it with lab testing. Options include isolating the virus from a sample of vesicular fluid, a Tzanck test (a stain histology test), and serum immunoglobulin antibody testing for HSV IgM (to detect acute HSV) and IgG (to detect a history of HSV). […] If you develop herpetic whitlow, follow your facility’s policy and procedure to prevent disease transmission. The Centers for Disease Control and Prevention recommends restricting health care providers from contact with patients or patient environments until lesions heal.

• #13 Swollen, purple, blistered thumb leads to diagnosis of herpetic whitlow

  https://www.contemporarypediatrics.com/view/swollen-purple-blistered-thumb-leads-to-diagnosis-of-herpetic-whitlow

  Herpetic whitlow refers to a superficial skin infection due to HSV, traditionally located on the fingers. It is most common within a bimodal age distribution, typically affecting infants or young adults. It is transmitted through direct skin-to-skin contact, and the majority of cases in children are due to HSV-1, the most common cause of oral herpes, also known as herpes labialis. However, it can also be caused by HSV-2, which causes most genital HSV infections. The most common presentations are young children with oral herpes who autoinoculate through sucking on fingers or toes, or in health care workers such as dentists who physically contact the mouth of an individual with oral herpes. Given various potential routes of transmission, it would be prudent to inquire about sexual activity in adolescents and adults, especially in the absence of exposure to an individual with oral HSV infection.

• #14 Herpetic Whitlow: Signs and Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/24681-herpetic-whitlow

  Herpetic whitlow is contagious and can spread from person to person. […] Infection is uncommon. An estimated 2 people per 100,000 receive a herpetic whitlow diagnosis in the United States. […] Yes, herpetic whitlow is contagious. The condition can spread from person to person through physical contact. […] Herpetic whitlow is a temporary, painful condition that typically resolves in two to three weeks. Antiviral treatment may be necessary to help the condition go away faster. […] A prompt medical evaluation will help confirm your diagnosis and establish treatment to offset signs and symptoms. Managing and preventing the infection is critical.

• #15 Herpetic Whitlow: Symptoms, Causes, and Diagnosis

  https://www.healthline.com/health/herpetic-whitlow

  Herpetic whitlow can occur due to an infection with the herpes simplex virus (HSV). […] Herpetic whitlow is a viral condition where small blisters form on the fingers and the fleshy area around the fingertips. […] Since the same virus causes herpetic whitlow, cold sores, and genital herpes, its extremely contagious. […] Symptoms of herpetic whitlow can appear 1 to 2 weeks after exposure to the virus. […] You can only develop this condition if your finger comes in contact with type 1 or type 2 HSV. […] If youve contracted HSV, herpetic whitlow may occur as a secondary condition. […] Doctors can usually identify viral conditions based on the appearance of sores or lesions. […] Herpetic whitlow doesnt require treatment. […] The condition usually heals within a few weeks without medication, but a prescription antiviral drug can shorten the duration of an outbreak.

• #16 The Problem of Herpetic Whitlow Among Hospital Personnel | Infection Control & Hospital Epidemiology | Cambridge Core

  https://www.cambridge.org/core/journals/infection-control-and-hospital-epidemiology/article/problem-of-herpetic-whitlow-among-hospital-personnel/9E4A25712AEBF50F17F44784E7BDF2D2

  Five cases of nosocomially acquired herpetic whitlow are presented; three cases developed following a common exposure. […] All infections were acquired despite the use of surgical gloves as recommended by existing guidelines on control of nosocomial infection. […] Revised guidelines for infection control should include the use of gloves on both hands whenever patient care involves contact with a debilitated patient with herpes simplex labialis.

• #17 Swollen, purple, blistered thumb leads to diagnosis of herpetic whitlow

  https://www.contemporarypediatrics.com/view/swollen-purple-blistered-thumb-leads-to-diagnosis-of-herpetic-whitlow

  Laboratory testing for herpetic whitlow does not necessarily need to be performed but can be helpful in confirming the diagnosis. The gold standard for this is PCR testing from an unroofed vesicle, which is the most sensitive diagnostic test and also allows for HSV typing. Other options include serology, Tzanck test, or lesion antigen detection, although these are less often used. Other studies, such as complete blood count, a metabolic profile, or C-reactive protein may be of use when considering other infectious etiologies or bacterial superinfection. […] Treatment of herpetic whitlow varies with presentation and clinical judgment. The infection is typically self-limited and most cases resolve in 2 to 4 weeks. Oral antiviral medications such as acyclovir or valacyclovir have been utilized for decades with significant success. These medications are relatively well tolerated with few adverse effects, and short-term use rarely leads to resistant HSV strains. They are especially useful for lesions present for less than 48 hours, recurrent lesions, or in immunocompromised patients.

• #18 Herpetic whitlow: a case report – Document – Gale Academic OneFile

  https://go.gale.com/ps/i.do?id=GALE%7CA11517602&sid=googleScholar&v=2.1&it=r&linkaccess=abs&issn=00943509&p=AONE&sw=w

  Herpetic whitlow refers to inflammation of the skin at the end of a finger caused by the herpes simplex virus. It is a relatively rare type of herpes infection to which health care workers are particularly susceptible. […] Diagnosis was confirmed by removing fluid from a vesicle and culturing it for the presence of herpes simplex virus. Herpetic whitlow occurs after direct exposure to the virus through a break in the skin. […] More serious complications include systemic viral infection and herpes infection of the eye.

• #19 Herpes simplex virus infections – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/herpes-simplex-virus-infections/

  More than 90% of the world’s population over the age of 40 years carries HSV. […] Herpetic whitlow is a manifestation of HSV infection that occurs on the finger. […] Commonly affected individuals include children and health care workers exposed to oral secretions (e.g., dentists). […] Herpetic whitlow typically presents as a cluster of vesicles on an erythematous base that progress to ulcerations. […] Surgical treatment is not indicated for herpetic whitlow and can lead to complications (e.g., inoculation of uninfected skin, bacterial superinfection).

• #20 Herpetic Whitlow: Symptoms, Causes, and Diagnosis

  https://www.healthline.com/health/herpetic-whitlow

  Due to the contagious nature of this condition, you should keep the blistered area covered until it heals. […] Unfortunately, theres currently no cure for HSV, though researchers are making progress on future treatments. […] In the event of recurrent outbreaks, your doctor may prescribe antiviral medication to help decrease the frequency of attacks.

• #21 Acute Hand Infections | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0215/p228.html

  Herpetic whitlow is caused by herpes simplex virus and typically resolves without intervention. […] Herpetic whitlow is a viral infection of the distal finger caused by inoculation of herpes simplex virus through broken skin. Vesicles of clear fluid on an erythematous base appear within three to four days of exposure to the virus, often coalescing into bullae. […] Mainstays of therapy for herpetic whitlow include reducing the risk of transmission, pain control, and consideration of antiviral medications. Primary herpetic whitlow is typically self-limited, with complete resolution within 21 days. However, off-label use of oral antivirals should be considered for patients with recurrent lesions or symptoms present for less than 48 hours, or for immunocompromised patients, who may develop disseminated disease requiring intravenous antiviral treatment and critical care. […] Recurrence occurs in 20% to 50% of cases.

• #22 Conflicting results from Herpes vaccine | American Association for the Advancement of Science (AAAS)

  https://www.aaas.org/taxonomy/term/9/conflicting-results-herpes-vaccine

  There are many types of Herpes viruses; including Herpes Simplex, Varicella Zoster (chickenpox causing virus), cytomegalovirus and many others. […] Indeed, they can even lead to local infection on the finger (herpetic whitlow) and many other anatomical regions as well. […] The problem with HSV infections are that they are recurrent. Moreover, once infected, patients remain carriers for life. […] Management of patients infected by either of these viruses is currently limited to antiviral medication which can shorten the duration and/or decrease the severity of symptoms. […] As a result there has been substantial interest in HSV disease prevention.

• #23 Nongenital Herpes Simplex Virus | AAFP

  https://www.aafp.org/pubs/afp/issues/2010/1101/p1075.html

  HSV-1 is initially transmitted in childhood via nonsexual contact, but it may be acquired in young adulthood through sexual contact. In the United States, the seroprevalence of HSV-1 decreased from 62.0 percent between 1988 and 1994 to 57.7 percent between 1999 and 2004.1 In a cross-sectional survey of U.S. college students, the prevalence of HSV-1 antibodies was 37.2 percent in freshmen and 46.1 percent in fourth-year students.2 A history of cold sores was reported in 25.6 percent of freshmen and 28 percent of fourth-year students. Significant predictors of HSV-1 antibodies in this population were female sex, sexual intercourse before 15 years of age, greater total years of sexual activity, history of a partner with oral sores, and personal history of a non-HSV sexually transmitted disease.2 Approximately 90 percent of recurrent HSV-1 infections cause the orofacial lesions known as herpes labialis3. […] Herpetic whitlow is a vesicular lesion found on the hands or digits. It occurs in children who suck their thumbs or medical and dental workers exposed to HSV-1 while not wearing gloves. […]

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