Materiały źródłowe

• #1 Herpetic Whitlow – StatPearls – NCBI Bookshelf

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

  Herpes simplex virus (HSV) is common and is most often transmitted in childhood through direct physical contact. Rarely, the infection may be spread to the distal phalanx via direct inoculation and cause pain, swelling, erythema, and vesicles in an entity known as herpetic whitlow. This diagnosis is of particular importance given its close similarity on presentation to paronychia and its drastically differing treatment. […] 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. […] Exposure to the herpes virus type 1 or type 2 results in viral invasion and replication in epidermal and dermal cells. This may progress to involve the sensory dorsal root ganglion, where latency is established. Infection usually occurs 2 to 20 days following exposure. One or more vesicles appear around the nail, and they usually coalesce into large, honeycomb-like bullae in 5 to 6 days. They may spread proximally and may also involve the nail bed. The infection is usually self-limited and resolves in 2-4 weeks.

• #1 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%. […] As in other mucocutaneous herpetic infections, herpetic whitlow is initiated by viral inoculation of the host through exposure to infected body fluids via a break in the skin, most commonly a torn cuticle. The virus then invades the cells of the dermis and subcutaneous tissue, and clinical infection ensues within a matter of days. […] Similarly, in healthcare workers, infection with HSV-1 is more common and usually is secondary to unprotected exposure to infected oropharyngeal secretions of patients. This easily can be prevented by use of gloves and by scrupulous observation of universal fluid precautions.

• #1 Herpetic Whitlow: Background, Pathophysiology, Epidemiology

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

  In the general adult population, herpetic whitlow is most often due to autoinoculation from genital herpes; therefore, it is most frequently secondary to infection with HSV-2. […] As is typical of other herpetic infections, herpetic whitlow is characterized by a primary infection, which may be followed by a latent period with subsequent recurrences. After the initial infection, the virus enters cutaneous nerve endings and migrates to the peripheral ganglia and Schwann cells where it lies dormant. The primary infection usually is the most symptomatic. Recurrences observed in 20-50% of cases are usually milder and shorter in duration.

• #1 Herpetic whitlow: Symptoms, causes, and treatment

  https://www.medicalnewstoday.com/articles/317701

  Herpetic whitlow, or whitlow finger, is a painful infection caused by the herpes simplex virus (HSV). It forms when a type of HSV enters the skin around the finger, leading to redness, soreness, and fluid-filled blisters. […] Herpetic whitlow develops when HSV enters a finger, particularly the fingertip, often through a small cut in the skin. Less commonly, whitlow can form on a toe. […] A person can develop herpetic whitlow through direct contact with skin containing the virus, which might be on the genitals, face, or hands. The transmission might involve: touching these areas of someone with active oral or genital sores, a person touching their own cold or genital sores, a person sucking their thumb or biting their nails during an oral herpes outbreak. […] The following factors can trigger reoccurring flares of HSV infection, including herpetic whitlow: a fever, a reoccurring illness, excessive stress, hormonal imbalances, excessive sun exposure, surgery, physical, mental, or emotional trauma, a weakened immune system.

• #1 Herpetic Whitlow Condition, Treatments and Pictures for Adults – Skinsight

  https://skinsight.com/skin-conditions/herpetic-whitlow/

  Herpetic whitlow, also called digital herpes simplex, finger herpes, or hand herpes, is a painful viral infection occurring on the fingers or around the fingernails. Herpetic whitlow is caused by infection with herpes simplex virus (HSV). […] People can develop herpetic whitlow when they come into contact with areas already infected with HSV, either on their own bodies or on someone else’s body. Usually, there is a break in the skin, especially a torn cuticle at the base of the fingernail, which allows the virus to enter the finger tissue and establish an infection. Both HSV-1 and HSV-2 can cause herpetic whitlow infections. […] In these groups of people—children and health care workers—herpetic whitlow is most commonly caused by HSV-1. In others, herpetic whitlow is usually caused by infection with HSV-2.

• #1 Herpes Simplex Virus (HSV) – Herpes Whitlow and Manicures — Medilex: The Experts on Medical Experts

  https://medilexinc.com/a-spoonful-of-medicine-blog/herpes-simplex-virus-hsv-herpes-whitlow-and-manicures

  Herpes simplex virus, type 1 or type 2, causes viral-mediated cellular death and associated inflammatory response. A herpes whitlow is a painful herpetic infection of a finger, fingers, and/or fingertips. It can be caused by any of the herpes strains. A whitlow causes pain, itching, redness, blister formation, and swelling. Herpetic whitlow can be recurrent, causing multiple painful outbreaks every year over the course of several years or even be lifelong. […] Typically, herpes virus infections are acquired by direct contact with skin or mucous membranes that are infected with the virus, however, the herpes virus can survive on inanimate objects and remain infectious for hours. When a nail bed suffers microtrauma from the action of a nail file, nail clipper, or a chemical solutionthings commonly utilized in nail salons as in this casethe skins normal defense mechanisms become injured and impaired, potentially allowing for entry of herpes virus into the cells. With sufficient injury and sufficient viral exposure, a herpes infection will occur. In short, trauma-induced skin injury during a manicure can weaken the protection normally afforded by the skin and allow herpes virus to enter. That infection will be lifelong.

• #1 What Is Herpetic Whitlow?

  https://www.icliniq.com/articles/infectious-diseases/herpetic-whitlow

  Herpetic whitlow is a condition caused by the herpes simplex virus (HSV), resulting in small, painful blisters on the fingers and fingertips. […] The infection often occurs as a sequel to local trauma to the nail cuticle. The exposure to the herpes virus is through self (pre-existing infection in other parts of the body) or contact with infected individuals. […] In rare cases, the virus spreads to the fingertips through an open wound and causes pain, swelling, erythema, and blisters known as herpetic whitlow. […] The stages of herpetic whitlow are as follows: Initial Stage: The initial stage lasts one to three days. Symptoms include redness, swelling, tenderness on the affected finger or thumb, and the appearance of small and painful blisters or vesicles. […] Vesicular Stage: It lasts four to seven days. Symptoms include rupturing blisters and forming shallow ulcers. These ulcers are painful and have a greyish or yellow base.

• #1 What Is Herpetic Whitlow?

  https://www.icliniq.com/articles/infectious-diseases/herpetic-whitlow

  Ulcerative Stage: It takes seven to 14 days. During this stage, the ulcers enlarge and become more painful. […] Healing Stage: This stage lasts 14 to 28 days. During this stage, the ulcers begin to heal, and the skin may be sensitive with residual redness. […] Resolution Stage: This stage starts after 28 days. The skin returns to normal, and no scars will form. […] The symptoms often appear one to two weeks after exposure to the virus. The first noticeable symptoms are pain and the tingling sensation of the infected finger. […] In patients with reduced immunity, ulcerations and necrosis can be seen. […] Recurrence of herpetic whitlow has been noted in 30 to 50 percent of the cases (due to latent sensory ganglion infection). Recurrent herpetic whitlow is treated by suppressive therapy with an antiviral agent. […] The complications arise as herpetic whitlow is often misdiagnosed as a paronychia (a localized bacterial abscess in the nail fold) or bacterial felon (digital pulp abscess).

• #1 Herpetic Whitlow – StatPearls – NCBI Bookshelf

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

  Symptomatic relief and avoidance of secondary infection are the mainstays of therapy for herpetic whitlow. The natural course of the infection in an immunocompetent patient is a spontaneous resolution of symptoms in 2 to 4 weeks. Incision and drainage should not be performed as it provides no symptomatic relief and may cause viremia and bacterial superinfection. […] While there are few studies specific to herpetic whitlow, antivirals have been shown to shorten the duration of symptoms by up to 4 days in one study and decreased days of positive viral culture. Data is especially favorable if the antiviral is started within 48 hours of the onset of symptoms. […] Herpetic whitlow is classically self-limited and usually resolves in 2 to 4 weeks for primary infection. After the acute stage, the pain abates, and the vesicles begin to dry and crust. Usually, the pain resolves in about 14 days, and the remaining skin changes continue to heal after that. Fingers and nails typically completely heal with no further issues, although there are reports of residual scarring, numbness, and hypersensitivity. […] A recurrent outbreak due to latent sensory ganglion infection has been noted in up to 30% to 50% of cases.

• #1 Herpetic whitlow | Symptoms Causes Preventions | Optimists Healthcare

  https://optimists.in/health-hub/herpetic-whitlow/

  Herpetic whitlow (whitlow finger) is a painful finger infection that develops due to the herpes virus. The condition is treatable but can come back. […] Herpes simplex causes herpetic whitlow, and you can develop the condition by touching another person’s blister or cold sore. […] You are more likely to develop herpetic whitlow if you have had genital herpes or cold sores. You may also develop it through a weakened immune system (if you have diabetes or are undergoing chemotherapy). The first time developing, the condition will be more severe. […] Once you have the herpes virus, it will stay in your body for the rest of your life. Though the condition is rare, if you get it once, the chances of developing it again will increase. There is not much to prevent herpetic whitlow, but it is similarly treatable if it comes back.

• #1 Whitlow: Symptoms, Causes, and Treatments

  https://resources.healthgrades.com/right-care/infections-and-contagious-diseases/whitlow

  Although no treatment will eliminate HSV from your body, your doctor may prescribe medications to improve the symptoms of the infection. […] Antiviral medications are among the most effective treatments for HSV infections. […] You can help minimize your risk of serious complications by following your healthcare professional’s treatment plan. […] Possible complications of whitlow include: numbness, scarring, bacterial infections, severe and recurring infections, herpes encephalitis. […] You may be able to lower your risk of whitlow or prevent the spread of HSV by: avoiding direct contact with open herpes lesions, including cold sores and genital lesions, avoiding sharing objects that have been in contact with saliva, practicing safe sex by using a barrier method such as a condom, not having sex while symptomatic.

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

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

  Symptomatic relief and avoidance of secondary infection are the mainstays of therapy for herpetic whitlow. […] Herpetic whitlow is classically self-limited and usually resolves in 2 to 4 weeks for primary infection. […] A recurrent outbreak due to latent sensory ganglion infection has been noted in up to 30% to 50% of cases. […] Herpetic whitlow is frequently misdiagnosed as a bacterial paronychia or felon. This may result in procedures that increase the risk of bacterial superinfection, systemic infection, and even the possible development of herpes encephalitis.

• #1 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. […] Exposure to the herpes virus type 1 or type 2 results in viral invasion and replication in epidermal and dermal cells. This may progress to involve the sensory dorsal root ganglion, where latency is established. Infection usually occurs 2 to 20 days following exposure. […] The diagnosis of a herpetic infection can be made by performing a microscopic examination of the margin of the vesicles in a Tzanck test. […] Herpetic whitlow is typically a clinical diagnosis. […] The diagnosis of herpetic whitlow is typically made by the appearance of lesions and the patients history.

• #1

  https://www.orthobullets.com/hand/6100/herpetic-whitlow

  Herpetic Whitlow is a viral infection of the hand caused by herpes simplex virus (HSV-1). […] Pathophysiology: viral shedding occurs while vesicles are forming bullae. […] Diagnosis is made clinically by presence of a small, vesicular rash and confirmed with a Tzank smear. […] Diagnosis is made with careful history and physical examination and confirmed with a positive Tzank smear.

• #1 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 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 initial presentation of herpetic whitlow is 1 or more vesicles that may be clear or yellow in color with surrounding erythema. They are often accompanied by numbness and tingling, burning pain, and/or pruritus of the affected region. Over time, vesicles may coalesce, satellite lesions may appear, and the site may become hemorrhagic or otherwise discolored. Initial pain typically abates but edema, erythema, and pruritus may continue until resolution of the lesions. Systemic features such as fever, lymphangitis, or regional lymphadenopathy have also been noted. These may be signs of a complication, the most common being bacterial superinfection, typically with Staphylococcus aureus. This can lead to impetigo, cellulitis, or abscess formation, which require antibiotic therapy. 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. 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. Keeping the lesions clean and dry is key to preventing bacterial superinfection. […] The thumb lesions had expanded and become confluent, with blisters now extending under his thumbnail. […] Herpetic whitlow demonstrates a characteristic vesicular pattern, but after several days vesicles commonly combine and form a larger, necrotic, bullous lesion.

• #1 Herpetic Whitlow – Musculoskeletal and Connective Tissue Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/musculoskeletal-and-connective-tissue-disorders/hand-disorders/herpetic-whitlow

  Herpetic whitlow is a cutaneous infection of the distal aspect of the finger caused by herpes simplex virus. […] Herpetic whitlow may cause intense pain, redness, and swelling of the finger. […] The intense pain can simulate a felon, but herpetic whitlow can usually be differentiated by the absence of tenseness in the pulp or the presence of vesicles. […] Herpetic whitlow can also mimic paronychia or other viral infections in the hand (eg, coxsackievirus). […] The condition is self-limited but may recur. […] Incision and drainage are contraindicated. […] Topical acyclovir 5% can shorten the duration of a first episode. […] Oral acyclovir (800 mg orally 2 times a day) may prevent recurrences if given immediately after onset of symptoms.

• #1 Herpetic Whitlow Symptoms, Causes and Treatment

  https://www.verywellhealth.com/herpetic-whitlow-overview-4584881

  Herpetic whitlow is a rare complication of herpes simplex virus (HSV) infection that leads to a painful rash in the finger or hand. […] Herpetic whitlow is a viral infection of the finger caused by the herpes simplex virus (HSV). […] What happens biologically is that once the skin is broken and HSV enters the body, the virus infects human epithelial cells, replicates, and symptoms occur. […] Recurrent infections occur when the herpes simplex virus which lies dormant in a nerve bundle emerges and causes symptoms. […] Rarely, herpetic whitlow causes a disseminated HSV infection when the virus has spread from its local site to other areas of the body, like the brain or spinal cord. This is a very serious complication and requires hospitalization.

• #1 Herpetic whitlow – Wikiwand

  https://www.wikiwand.com/en/articles/herpetic_whitlow

  Although it is a self-limited illness, oral or intravenous antiviral treatments, particularly acyclovir, have been used in the management of immunocompromised or severely infected patients. It is usually given when the condition fails to improve on its own. […] Even though the disease is self-limiting, as with many herpes infections, the virus lies dormant in the peripheral nervous system. The disease recurs in about 2050% of people. The most severe infection is usually the first one, with recurrences subsequently getting milder.

• #1 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. Again, 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.

• #1 Whitlow: Symptoms, Causes, and Treatments

  https://resources.healthgrades.com/right-care/infections-and-contagious-diseases/whitlow

  Several factors can increase the risk of developing whitlow, including: having a career in a healthcare profession that involves frequent exposure to people with infections, such as dentistry or nursing, having HIV, having a broken skin surface, nail biting or thumb sucking, engaging in any sexual activity that brings you into close contact with bodily fluids from a person with HSV.

• #1 Indolent herpetic whitlow of the toe in an elderly patient with diabetic neuropathy

  https://escholarship.org/uc/item/1cs0p0tw

  We report a case of indolent herpetic whitlow of the toe occurring in an elderly male patient with poorly controlled diabetes mellitus. […] Herpetic whitlow is a painful infection caused by the herpes simplex virus (HSV) mostly affecting the hands and fingers. […] The present case is atypical in that herpetic whitlow developed in the toe. Furthermore it lacked the characteristic pain that is usually a clue to the clinician that a lesion not responding to antibacterial treatment may be of herpetic origin. […] The clinical symptoms of herpetic whitlow characteristically begin with intense itching or pain in the infected finger or toe. In the present case, however, there was no pain in the toe because of his diabetic neuropathy, which made its early diagnosis more difficult. […] Precise mechanisms for some skin infections to be more common in diabetics is still unclear, however, Cooppan postulated that high frequency of infection in diabetics could be attributed to dehydration, dysfunction of polymorphonuclear leukocytes, microangiopathy, and neuropathy.

• #1 Whitlow – Knowledge and References – Taylor & Francis

  https://taylorandfrancis.com/knowledge/Medicine_and_healthcare/Occupational_%26_environmental_medicine/Whitlow/

  A whitlow is a type of infection that affects the skin and fibro-fatty pulp of the finger, and is caused by the herpes simplex virus. It is characterized by pain and swelling, and is often accompanied by a purulent or vesicular lesion located at the tip of the finger. […] Herpetic whitlow is highly contagious up to 7 days after the vesicles are healed, so avoidance of close contacts should be counseled. Medical personnel should be vigilant as latex gloves may only decrease transmission. […] HSV also has a significant interaction with HIV, as HSV-2 infection quadruples the risk of transmitting HIV infection and also increases 2- to 3- fold the chances of acquiring the disease. […] Others include ocular herpes, herpes gladiatorum, herpetic whitlow, neonatal herpes and so on.

• #1 Herpes Virus Gives Man a Blistery Finger Infection | Live Science

  https://www.livescience.com/51054-whitlow-finger-infection-herpes.html

  Whitlow generally starts around the fingernail and then spreads to the rest of the finger. The infection takes root when there is a wound in the finger, allowing a pathogen to enter and multiply. […] But in cases of whitlow caused by bacteria, the sores often have pus, whereas herpetic whitlow produces small blisters on the skin that are filled with a clear or yellowish fluid, which contains the herpes virus, he said. […] The symptoms of a herpes virus infection usually subside on their own, but the virus hibernates within the body’s nerve cells, Gathier said. Certain triggers, such as stress, can cause it to become active again, resulting in outbreaks. […] The infection can spread to the entire hand, and sometimes even to the tendon, which is „very hard to treat and will generally require surgery of the hand,” Gathier said.

• #1 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.

• #1 Herpetic whitlow: Symptoms, causes, and treatment

  https://www.medicalnewstoday.com/articles/317701

  Without treatment, herpetic whitlow tends to go away in 24 weeks. To reduce the duration of the symptoms, a person can try antiviral medications. These limit the appearance of symptoms by up to 4 days. Antiviral medications also prevent the virus from spreading to other parts of the body. […] If a secondary bacterial infection develops in the area of a whitlow infection, antibiotics may also be necessary. […] It is worth noting that while antiviral drugs can reduce the frequency and severity of symptoms, there is no cure for an HSV infection. […] The HSV can stay inactive in the nerve cells for some time. It may or may not reactivate and cause symptoms.

• #2 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%. […] As in other mucocutaneous herpetic infections, herpetic whitlow is initiated by viral inoculation of the host through exposure to infected body fluids via a break in the skin, most commonly a torn cuticle. The virus then invades the cells of the dermis and subcutaneous tissue, and clinical infection ensues within a matter of days. […] Similarly, in healthcare workers, infection with HSV-1 is more common and usually is secondary to unprotected exposure to infected oropharyngeal secretions of patients. This easily can be prevented by use of gloves and by scrupulous observation of universal fluid precautions.

• #2 Herpetic Whitlow Condition, Treatments and Pictures for Adults – Skinsight

  https://skinsight.com/skin-conditions/herpetic-whitlow/

  Herpetic whitlow, also called digital herpes simplex, finger herpes, or hand herpes, is a painful viral infection occurring on the fingers or around the fingernails. Herpetic whitlow is caused by infection with herpes simplex virus (HSV). […] People can develop herpetic whitlow when they come into contact with areas already infected with HSV, either on their own bodies or on someone else’s body. Usually, there is a break in the skin, especially a torn cuticle at the base of the fingernail, which allows the virus to enter the finger tissue and establish an infection. Both HSV-1 and HSV-2 can cause herpetic whitlow infections. […] In these groups of people—children and health care workers—herpetic whitlow is most commonly caused by HSV-1. In others, herpetic whitlow is usually caused by infection with HSV-2.

• #2 Herpes Simplex Virus (HSV) – Herpes Whitlow and Manicures — Medilex: The Experts on Medical Experts

  https://medilexinc.com/a-spoonful-of-medicine-blog/herpes-simplex-virus-hsv-herpes-whitlow-and-manicures

  Herpes simplex virus, type 1 or type 2, causes viral-mediated cellular death and associated inflammatory response. A herpes whitlow is a painful herpetic infection of a finger, fingers, and/or fingertips. It can be caused by any of the herpes strains. A whitlow causes pain, itching, redness, blister formation, and swelling. Herpetic whitlow can be recurrent, causing multiple painful outbreaks every year over the course of several years or even be lifelong. […] Typically, herpes virus infections are acquired by direct contact with skin or mucous membranes that are infected with the virus, however, the herpes virus can survive on inanimate objects and remain infectious for hours. When a nail bed suffers microtrauma from the action of a nail file, nail clipper, or a chemical solutionthings commonly utilized in nail salons as in this casethe skins normal defense mechanisms become injured and impaired, potentially allowing for entry of herpes virus into the cells. With sufficient injury and sufficient viral exposure, a herpes infection will occur. In short, trauma-induced skin injury during a manicure can weaken the protection normally afforded by the skin and allow herpes virus to enter. That infection will be lifelong.

• #2

  https://europepmc.org/books/n/statpearls/article-22848/?extid=30085539&src=med

  Herpes simplex virus (HSV) is common and is most often transmitted in childhood through direct physical contact. Rarely, the infection may be spread to the distal phalanx via direct inoculation and cause pain, swelling, erythema, and vesicles in an entity known as herpetic whitlow. […] 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. […] Exposure to the herpes virus type 1 or type 2 results in viral invasion and replication in epidermal and dermal cells. This may progress to involve the sensory dorsal root ganglion, where latency is established. Infection usually occurs 2 to 20 days following exposure.

• #2 Herpetic Whitlow: Background, Pathophysiology, Epidemiology

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

  In the general adult population, herpetic whitlow is most often due to autoinoculation from genital herpes; therefore, it is most frequently secondary to infection with HSV-2. […] As is typical of other herpetic infections, herpetic whitlow is characterized by a primary infection, which may be followed by a latent period with subsequent recurrences. After the initial infection, the virus enters cutaneous nerve endings and migrates to the peripheral ganglia and Schwann cells where it lies dormant. The primary infection usually is the most symptomatic. Recurrences observed in 20-50% of cases are usually milder and shorter in duration.

• #2

  https://europepmc.org/books/n/statpearls/article-22848/?extid=30085539&src=med

  One or more vesicles appear around the nail, and they usually coalesce into large, honeycomb-like bullae in 5 to 6 days. They may spread proximally and may also involve the nail bed. The infection is usually self-limited and resolves in 2-4 weeks. […] The diagnosis of herpetic whitlow is typically made by the appearance of lesions and the patients history. […] Symptomatic relief and avoidance of secondary infection are the mainstays of therapy for herpetic whitlow. The natural course of the infection in an immunocompetent patient is a spontaneous resolution of symptoms in 2 to 4 weeks. […] While there are few studies specific to herpetic whitlow, antivirals have been shown to shorten the duration of symptoms by up to 4 days in one study and decreased days of positive viral culture. […] Herpetic whitlow is classically self-limited and usually resolves in 2 to 4 weeks for primary infection. […] A recurrent outbreak due to latent sensory ganglion infection has been noted in up to 30% to 50% of cases.

• #2 What Is Herpetic Whitlow?

  https://www.icliniq.com/articles/infectious-diseases/herpetic-whitlow

  Ulcerative Stage: It takes seven to 14 days. During this stage, the ulcers enlarge and become more painful. […] Healing Stage: This stage lasts 14 to 28 days. During this stage, the ulcers begin to heal, and the skin may be sensitive with residual redness. […] Resolution Stage: This stage starts after 28 days. The skin returns to normal, and no scars will form. […] The symptoms often appear one to two weeks after exposure to the virus. The first noticeable symptoms are pain and the tingling sensation of the infected finger. […] In patients with reduced immunity, ulcerations and necrosis can be seen. […] Recurrence of herpetic whitlow has been noted in 30 to 50 percent of the cases (due to latent sensory ganglion infection). Recurrent herpetic whitlow is treated by suppressive therapy with an antiviral agent. […] The complications arise as herpetic whitlow is often misdiagnosed as a paronychia (a localized bacterial abscess in the nail fold) or bacterial felon (digital pulp abscess).

• #2 Herpetic whitlow (whitlow finger) | nidirect

  https://www.nidirect.gov.uk/conditions/herpetic-whitlow-whitlow-finger

  Herpetic whitlow is caused by a virus called herpes simplex. You can get it if you touch a cold sore or blister of another infected person. […] You’re more likely to get herpetic whitlow if you’ve had cold sores or genital herpes. […] You may also get it if you have a weakened immune system for example, if you have diabetes or you’re having chemotherapy. […] The first time you have herpetic whitlow will usually be the most severe. […] Once you have the virus, it stays in your body for the rest of your life. […] The condition is rare, but if you get it once you can get it again. For example, it might come back if you have a cut or sore on your finger, or if you’re feeling stressed or unwell. […] There’s not much you can do to prevent herpetic whitlow. But it can be treated in the same way if it comes back.

• #2 Dealing with herpetic whitlow

  https://canadianfirstaid.ca/dealing-with-herpetic-whitlow/

  Herpetic whitlow is an infection of the fingertip that causes severe pain. This condition is caused by the herpes simplex virus (HSV). The condition causes severe pain and blisters. […] Avoid being stressed to prevent the development of herpetic whitlow. Minimize stress and boost the immune system by eating healthy meals, maintain good sleeping habits and regular exercise for proper flow of blood in the area. […] Reduce the levels of stress to prevent a dormant HSV virus from becoming activated.

• #2 A man with an infected finger: a case report | Journal of Medical Case Reports | Full Text

  https://jmedicalcasereports.biomedcentral.com/articles/10.1186/s13256-015-0589-5

  Whitlow is an infection of a finger or around the fingernails, generally caused by bacterium. However, in rare cases, it may also be caused by the herpes simplex virus. […] Herpetic whitlow is an infrequently seen cause of infection of a finger. It is caused by the herpes simplex virus type 1 (60%) or type 2 (40%). […] Delayed recognition and/or treatment puts patients at risk of complications ranging from superinfection to herpetic encephalitis. […] On the basis of the clinical appearance we considered herpetic whitlow with superinfection. […] The herpes simplex virus causes two types of infections: primary and recurrent. Usually, a break in the skin barrier (for example a wound) allows the virus to enter the tissue and establish an infection. […] Whitlow is rarely caused by the herpes simplex virus, but this disease requires swift recognition and treatment to prevent complications. […] As this treatment differs from that of a traditional whitlow, physicians should be aware of herpetic whitlow.

• #2 Untreated herpetic whitlow can cause severe brain infection – Expert – Punch Newspapers –

  https://punchng.com/untreated-herpetic-whitlow-can-cause-severe-brain-infection-expert/

  Herpetic whitlow is a painful infection of one or more fingers, caused by a virus called herpes simplex virus and mostly affecting the end part of the fingers. […] It is commonly caused by exposure to body fluid containing the virus (HSV), such as the fluid from the blisters of cold sores in the mouth or affected genital areas. Autoinoculation easy transfer of the virus from one body part affected by herpetic lesions, e.g. genital or mouth herpes, to the unaffected parts (that is the fingers in this case) can cause herpetic whitlow. […] The late symptoms may be severe and include spread to internal organs leading to infection of the internal organs (sepsis) and brain involvement (encephalitis) especially in people with low immunity. […] The physical effects are mainly related to combined or super-imposed bacterial infection or infection resulting from mistaken surgical drainage due to incorrect diagnosis of this viral infection as a paronychia, which is a bacterial infection. […] Other physical impacts may include severe pain, delayed healing, bacterial infection combined with the herpetic whitlow, and, rarely, systemic spread to the brain causing herpes encephalitis. Herpetic whitlow, if untreated, can cause severe brain infection.

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

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

  Symptomatic relief and avoidance of secondary infection are the mainstays of therapy for herpetic whitlow. […] Herpetic whitlow is classically self-limited and usually resolves in 2 to 4 weeks for primary infection. […] A recurrent outbreak due to latent sensory ganglion infection has been noted in up to 30% to 50% of cases. […] Herpetic whitlow is frequently misdiagnosed as a bacterial paronychia or felon. This may result in procedures that increase the risk of bacterial superinfection, systemic infection, and even the possible development of herpes encephalitis.

• #2 Herpetic whitlow: Symptoms, causes, and treatment

  https://www.medicalnewstoday.com/articles/317701

  Without treatment, herpetic whitlow tends to go away in 24 weeks. To reduce the duration of the symptoms, a person can try antiviral medications. These limit the appearance of symptoms by up to 4 days. Antiviral medications also prevent the virus from spreading to other parts of the body. […] If a secondary bacterial infection develops in the area of a whitlow infection, antibiotics may also be necessary. […] It is worth noting that while antiviral drugs can reduce the frequency and severity of symptoms, there is no cure for an HSV infection. […] The HSV can stay inactive in the nerve cells for some time. It may or may not reactivate and cause symptoms.

• #2 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 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 initial presentation of herpetic whitlow is 1 or more vesicles that may be clear or yellow in color with surrounding erythema. They are often accompanied by numbness and tingling, burning pain, and/or pruritus of the affected region. Over time, vesicles may coalesce, satellite lesions may appear, and the site may become hemorrhagic or otherwise discolored. Initial pain typically abates but edema, erythema, and pruritus may continue until resolution of the lesions. Systemic features such as fever, lymphangitis, or regional lymphadenopathy have also been noted. These may be signs of a complication, the most common being bacterial superinfection, typically with Staphylococcus aureus. This can lead to impetigo, cellulitis, or abscess formation, which require antibiotic therapy. 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. 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. Keeping the lesions clean and dry is key to preventing bacterial superinfection. […] The thumb lesions had expanded and become confluent, with blisters now extending under his thumbnail. […] Herpetic whitlow demonstrates a characteristic vesicular pattern, but after several days vesicles commonly combine and form a larger, necrotic, bullous lesion.

• #2 Herpetic Whitlow Condition, Treatments and Pictures for Adults – Skinsight

  https://skinsight.com/skin-conditions/herpetic-whitlow/

  Affected individuals carry the virus in their bodies for the rest of their lives. […] Certain triggers can cause the hibernating (latent) virus to wake up, become active, and travel back to the skin. These recurrent HSV infections may develop frequently (every few weeks), or they may never develop. Recurrent infections tend to be milder than primary infections and generally occur in the same location as the primary infection.

• #2 Herpes Virus Gives Man a Blistery Finger Infection | Live Science

  https://www.livescience.com/51054-whitlow-finger-infection-herpes.html

  Whitlow generally starts around the fingernail and then spreads to the rest of the finger. The infection takes root when there is a wound in the finger, allowing a pathogen to enter and multiply. […] But in cases of whitlow caused by bacteria, the sores often have pus, whereas herpetic whitlow produces small blisters on the skin that are filled with a clear or yellowish fluid, which contains the herpes virus, he said. […] The symptoms of a herpes virus infection usually subside on their own, but the virus hibernates within the body’s nerve cells, Gathier said. Certain triggers, such as stress, can cause it to become active again, resulting in outbreaks. […] The infection can spread to the entire hand, and sometimes even to the tendon, which is „very hard to treat and will generally require surgery of the hand,” Gathier said.

• #2 Herpetic Whitlow

  https://mobile.fpnotebook.com/Ortho/ID/HrptcWhtlw.htm

  Herpes Simplex Virus infection of the finger tip […] Infection via broken skin […] Herpetic Whitlow is self limited and resolves spontaneously without treatment […] Resolves spontaneously in 3 to 4 weeks […] Recurs in 20 to 50% of cases.

• #2 Whitlow: Symptoms, Causes, and Treatments

  https://resources.healthgrades.com/right-care/infections-and-contagious-diseases/whitlow

  Several factors can increase the risk of developing whitlow, including: having a career in a healthcare profession that involves frequent exposure to people with infections, such as dentistry or nursing, having HIV, having a broken skin surface, nail biting or thumb sucking, engaging in any sexual activity that brings you into close contact with bodily fluids from a person with HSV.

• #2 Herpetic whitlow – wikidoc

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

  Herpes whitlow is a painful infection that typically manifest itself on fingers or thumbs and occasionally on the toes, or on the nail cuticle, and is caused by HSV-1 or HSV-2. […] Herpes whitlow is also caused by autoinoculation of HSV into broken skin prior to an infected person developing antibodies against the virus (e.g. during primary infection before seroconversion). […] If someone has a cold sore and puts their finger in their mouth then a herpes infection whitlow may appear. Herpes whitlows are frequently found among dentists and dental hygienists.

• #2 Whitlow – Knowledge and References – Taylor & Francis

  https://taylorandfrancis.com/knowledge/Medicine_and_healthcare/Occupational_%26_environmental_medicine/Whitlow/

  A whitlow is a type of infection that affects the skin and fibro-fatty pulp of the finger, and is caused by the herpes simplex virus. It is characterized by pain and swelling, and is often accompanied by a purulent or vesicular lesion located at the tip of the finger. […] Herpetic whitlow is highly contagious up to 7 days after the vesicles are healed, so avoidance of close contacts should be counseled. Medical personnel should be vigilant as latex gloves may only decrease transmission. […] HSV also has a significant interaction with HIV, as HSV-2 infection quadruples the risk of transmitting HIV infection and also increases 2- to 3- fold the chances of acquiring the disease. […] Others include ocular herpes, herpes gladiatorum, herpetic whitlow, neonatal herpes and so on.

• #2 Herpetic whitlow – Mediclinic

  https://www.mediclinicinfohub.co.za/herpetic-whitlow/

  After the initial infection, the virus enters the peripheral nervous system (i.e. excluding the brain and spinal cord) where it lies dormant. […] Treatment with acyclovir will shorten the duration of the symptoms in primary infections. […] It acts by interfering with the DNA replications within the virus.

• #2 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). […] The herpes simplex virus (HSV) causes this condition. […] 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. […] This can happen if you have an open cut or sore on a finger that comes in contact with sores or blisters around your face or genital area. The virus can enter your finger through this cut. […] If you dont have a history of HSV, herpetic whitlow may develop if you come in contact with herpes sores or blisters, which can transmit the virus from one person to another. […] Antivirals are only effective when taken within 24 hours of developing symptoms. […] Unfortunately, theres currently no cure for HSV, though researchers are making progress on future treatments. […] Once an initial outbreak goes away, the virus may remain dormant in your body for years. […] So even after herpetic whitlow symptoms disappear, you could experience another outbreak later on, although this is unlikely.

• #3 Herpetic whitlow: Symptoms, causes, and treatment

  https://www.medicalnewstoday.com/articles/317701

  Herpetic whitlow, or whitlow finger, is a painful infection caused by the herpes simplex virus (HSV). It forms when a type of HSV enters the skin around the finger, leading to redness, soreness, and fluid-filled blisters. […] Herpetic whitlow develops when HSV enters a finger, particularly the fingertip, often through a small cut in the skin. Less commonly, whitlow can form on a toe. […] A person can develop herpetic whitlow through direct contact with skin containing the virus, which might be on the genitals, face, or hands. The transmission might involve: touching these areas of someone with active oral or genital sores, a person touching their own cold or genital sores, a person sucking their thumb or biting their nails during an oral herpes outbreak. […] The following factors can trigger reoccurring flares of HSV infection, including herpetic whitlow: a fever, a reoccurring illness, excessive stress, hormonal imbalances, excessive sun exposure, surgery, physical, mental, or emotional trauma, a weakened immune system.

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