Treatment

Herpetic whitlow is usually a self limiting condition and resolves within 2-3 weeks (1)

The lesion should not be drained due to the tendency for bacterial superinfection (2).

If the lesion is painful, topical antivirals are commenced e.g. acyclovir

Recurrence of the infection is reported in 30-50% of infected individuals

• recurrent infection is usually less severe than the initial infection (1)
• usually associated with type 2 HSV infection (2)
• antivirals initiated during the prodromal stage may be beneficial (1)

Reference:

• 1. Clark DC. Common acute hand infections. Am Fam Physician. 2003;68(11):2167-76
• 2. Klotz RW. Herpetic whitlow: an occupational hazard. AANA J. 1990;58(1):8-13
• 3. Smith E et al. Multiple herpetic whitlow lesions in a patient with chronic lymphocytic leukemia. Am J Hematol. 2002;69(4):285-8.