What is Herpetic Whitlow or Whitlow Finger?

Intensely painful infection of fingertips is commonly known as herpetic whitlow or whitlow finger. This infection can affect other fingers of your hand as well and there is involvement of terminal phalanx normally. It results in intense tenderness and swelling. The symptoms of herpetic whitlow or whitlow finger clear within 2 weeks. Herpetic simplex Virus 1 or also called HSV-1 is responsible for herpetic whitlow or whitlow finger disease in children who are below the age of eighteen while HSV 2 affects adults who are above the age of 18. Genital herpes is also caused by HSV type 2 infections.

Herpetic Whitlow or Whitlow Finger

At the initial stage of herpetic whitlow or whitlow finger you will encounter small red spots on the end of finger skin. With every passing minute its condition get worsens and it can turn into troubling lesion as well. People suffering from herpetic whitlow or whitlow finger have to face severe pain and their daily activities are interrupted. People of any age or gender can get affected by HSV-1 and HSV-2, this virus is rare but can raise your concern about occurring infections. In the United States less than five cases were reported for herpetic whitlow or whitlow finger in an area of 100,000 people population.

Causes of Herpetic Whitlow or Whitlow Finger

Viruses that are mostly produced in oral as well as genital secretions are the main reason behind herpetic whitlow or whitlow finger. HSV-1 & HSV-2 is the name given to the viruses which causes herpetic whitlow or whitlow finger. People working in healthcare industry and in dental clinics are regularly exposed to such a dangerous virus and thus there arise a possibility that these people may suffer from herpetic whitlow or whitlow finger. Low immunity individuals and HIV patients are at greater risk to herpetic whitlow or whitlow finger.

Children who are prone to mouth herpes usually become the victim of herpetic whitlow or whitlow finger. Children keep their fingers in the mouth and get in contact with the virus resulting in herpetic whitlow or whitlow finger. Thus, through small cuts and skin breaks this kind of virus get entry into human body. Auto Inoculation is the term given to such process. People coming in contact with infected individuals can also develop this herpetic whitlow or whitlow finger very quickly. According to medical research it has been stated that its symptoms develops in almost twenty days. You can feel burning sensation along with tingling and pain. Your finger can turn red, swollen as well as tender in short time. Tiny blister with red base usually occur on fingers and healing procedure of it can take up to two weeks' time. Fever and swollen lymph below the arm are few of the additional symptoms of this herpetic whitlow or whitlow finger.

Mostly an individual has to pass through severe pain which is a result of lesion. Virus becomes inactive (still present) once the signs are gone. There can be numerous other factors which can also trigger herpetic whitlow or whitlow finger again.

People of all age groups, irrespective of their race and sex, are the possible subject of herpetic whitlow or whitlow finger. However, it can be found with medical practitioners and dentists commonly. Herpetic whitlow or whitlow finger in children are mostly caused due to the contact of mouth and lips, infected of herpes, with fingers. Dentists and other medical practitioners may get infected through the contact of contagious lesions of patient, having HSV infection. It is the most common reason of spreading HSV-1 among kids and health care personnel's. Every other infection, other than earlier causes, is caused by herpetic whitlow or whitlow finger along with HSV-2.

Signs and Symptoms of Herpetic Whitlow or Whitlow Finger

  1. Red and swallowed fingertips with an extreme pain are the primary symptom of herpetic whitlow or whitlow finger.
  2. White blisters carrying fluid, developed beneath the skin is a symptom of herpetic whitlow or whitlow finger.
  3. Herpetic whitlow or whitlow finger is primarily occurs in thumb, index finger and other fingers.

Within 2 to 20 days since the initial exposure of the HSV, infected area starts giving the feel of tingling, burning and pain. After a week or two, it becomes more red and swelling in the form of fluid filled (1-3mm) blister, clustered over the bright red base. Finally it becomes ruptured and layered and then come to an end by next two weeks.

Some other primary infections associated with herpetic whitlow or whitlow finger can be enumerated as:

  • Lymphangitis, that is, red streaks blistering from the finger.
  • Fever.
  • Swelled lymph nodes at the elbow edge or beneath the underarms.

In case of self-developed ailment of herpetic whitlow or whitlow finger (autoinoculation), it is likely to be rooted from the genital or mouth portion, supposed to be infected with primary herpes simplex virus.

Recurring of herpes simplex virus infection is usually lasts for 7-10 days and is low in magnitude than that of earlier one, although it is rare to have again.

Recurred HSV infection has been recorded as lesions with burning, itching and tingling sensations. Tingling can be sensed in 24 hours since it begins where actual lesions use to appear as single or multiple small blisters, which eventually get ruptured and become scabbed over.

Recurring HSV infections can be identified through some symptoms, such as:

  • Sun exposure
  • Stress
  • Trauma
  • Illness or fever
  • Hormonal changes due to pregnancy and menstrual cycle
  • Surgery.

When to Seek Medical Care for Herpetic Whitlow or Whitlow Finger?

Any sort of painful sore on the finger is required to be consulted with a physician, particularly when it does not seem curing or gets worsened. A medical consultation is also required in case of existing symptoms of genital and oral herpes.

Tests to Diagnose Herpetic Whitlow or Whitlow Finger

To confirm herpetic whitlow or whitlow finger, definite diagnostic testing is suggested which comprises the various sorts of test, such as, serum antibody titers, Tzanck test, fluorescent antibody testing, viral cultures and DNA hybridization. Specimens are generally taken from the lesions which have been occurred in less than 24 hours.

Viral culture of the aspirated vesicle is the most precise examination which satisfies the diagnostic criterions for herpetic whitlow or whitlow finger as well. Viral culture is an expensive and time taking procedure, as it takes 24-48 hours, as well as it is the ideal examination to identify HSV-1 and HSV-2 separately.

Polymerase chain reaction (PCR) and immune fluorescent microscopy is cost effective and more widely available test facility for diagnosing herpetic whitlow or whitlow finger.

In short, the positive HSV can be confirmed by the help of couple of diagnosis procedure, virologic test (viral culture of the lesion) and serologic test (blood test which identifies antibodies).

Also Read:

Written, Edited or Reviewed By:

, MD, FFARCSI

Last Modified On: May 3, 2016

Pain Assist Inc.

Pramod Kerkar
  Note: Information provided is not a substitute for physician, hospital or any form of medical care. Examination and Investigation is necessary for correct diagnosis.

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