Dermatology  (Expert Forum)

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Herpetic Whitlow

Answered by
Alan Rockoff, MD - dermatology, Child Skin Problems
The Rockoff Dermatology Center Brookline - MA
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MedHelp Member's Question
Herpetic Whitlow
by Jefferson, Aug 07, 2001 12:00AM
Dr.

I had a horrible bout on my finger of what appeared to be herpetic whitlow.  I had an edema and a yellowish blister as well as some small other bumps scattered on both the edema and elsewhere on my hand.  The blister never opened but was quite painful.  The severe symptoms all took place on the lower portion of my index finger.  This condition seems to have a correlation to heat but that does not fit perfectly.  It does not look like ezcema (eczema) and I had never experienced it before this summer.

I am not sure how I could contract herpetic whitlow unless I had some form of herpes to begin with, which I don't think I do, but you never know.  Do you have any thoughts?  Is it possible to spread genital herpes to your hand?  And if this is whitlow, do I need a blood test for HSV II?

Thank you.
Doctor's Answer
by Alan Rockoff, MD, Aug 09, 2001 12:00AM
Herpes generally sets up shop in one place.  Once it's there, it recurs in that place but doesn't spread elsewhere, because antibodies in the bloodstream keep it from getting a toehold.  (Otherwise, everyone with a cold sore would spread herpes all over the body every time they washed their face.)

You can get whitlow from touching someone's mouth who is shedding herpes (e.g. dentists, hygienists.)  But most of the time, people with herpes anywhere have no real idea where it originally came from.

If recurrences are frequent or painful you should look into taking an oral antiviral pill wither all the time or as soon as an outbreak starts.  Of course, you'll want to be absolutley sure (by culture of a fresh outbreak) that what you had was really herpes and not, say, bacteria.

Best.

Dr. Rockoff
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