HERPETIC WHITLOW

Question 1

Herpetic whitlow definition

Answer 1

Viral infection of hand

Question 2

Aetiology of herpetic whitlow

Answer 2

Herpes simplex virus (HSV-1)

Question 3

Demographic groups most commonly affected by herpetic whitlow

Answer 3

1. Young children = toddlers and preschool children

2. Medical and dental personnel

Question 4

Key clinical features of herpetic whitlow

Answer 4

• Vesicular rash with intense burning pain
• Vesicles coalesce to form bullae = viral shedding
• Bullae scab and eventually cause superficial ulceration
• Patients may have fever, malaise, lymphadenitis

Question 5

Diagnosis of herpetic whitlow

Answer 5

Tzanck smear, culture or antibody titre

Question 6

Management of herpetic whitlow

Answer 6

Observation = self-limiting course with resolution of symptoms over 7-10 days
Acyclovir may shorten duration of symptoms
Never surgical debridement = can lead to superinfections, encephalitis and death

Question 7

Complications of herpetic whitlow

Answer 7

1. Recurrence = may be precipitated by stress, fever, sun exposure
2. Superinfections with surgical debridement