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- synonyms: Digital tip, hand and forearm infections caused by herpes simplex virus 1 and 2.
ICD-10
- B00.89: Other herpesviral infection
ICD-9
- 054.6 Herpetic whitlow Herpetic felon
Herpetic Whitlow Anatomy
Herpetic Whitlow Clinical Evaluation
- Generally occur in patients with occupations involving orotracheal contact such as oral hygenists and dentist. Can occur from autoinoculation from genital and oral lesions.
- Painful vesicles from 2-14 days after exposure and susequently unroof forming characteristic ulcers.
- Evaluate for lympadenitis.
- May be associated with fever and malaise.
- Diagnosis can be confirmed with cultures of vesicular fluid, Tzanck smear or a rise in serum antibody titers. Laboratory confirmation is not necesary for characteristic lesions.
Herpetic Whitlow Xray
- Consider A/P and lateral of affected digit. Usually not needed lesions are characteristic. Indicated to rule out foreign body and osteomyelitis if any concern exists
Herpetic Whitlow Classification / Treatment
- Lesions are self-limited and resolve over 7-10 days.
Herpetic Whitlow Follow-up Care
- Lesions are infections until they are completely epithelialized.
- Virus enters latent state after infection and may recure. Recurrences can be induced by psychological or physical stress, fever, other infections, and sun exposure.
Herpetic Whitlow Differential Diagnosis
- Cellulitis
- Paronychia
- Herpetic Whitlow
- Flexor Tendon Tenosynovitis
Herpetic Whitlow Complications
- Superinfection may occur if lesion is mistaken for a felon and is treated with incision and drainage.
Herpetic Whitlow References
- Abrams RA, JAAOS 1996;4:219
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