Whitlow

Original Editor - User:e Kehinde FatolaKehinde Fatola
Top Contributors - Kehinde Fatola, Joao Costa, Shaimaa Eldib and Temitope Olowoyeye

Introduction

Whitlow is a very painful and infectious viral disease of the thumb and fingertips. Rarely, it infects the toes and nail cuticle. It is a self-limiting disease and it is of two types - Herpetic Whitlow and Melanotic Whitlow. Herpetic whitlow is more prevalent of the two. It is a disease of the hand.

Mechanism of Injury / Pathological Process

Herpetic whitlow is caused by the Herpetic Simplex Virus (HSV). HSV is of two types - type 1 and type 2. They are both known to cause whitlow. Herpetic whitlow is caused when a wounded and exposed skin comes in contact with body fluids contaminated with HSV. It may also be caused by bacterial fingertip infection.

Risk factors include;

• Human Immunodeficiency Virus (HIV) infection
• Nail biting habit
• Wounded finger with exposed skin surface
• Career in health care profession

Clinical Presentation

The finger may present with;

• Tingling
• Itchy feeling
• Burning sensation
• Blisters
• Redness, warmth or swelling

The body may present generally with;

• Fever
• Lymphangitis
• Blisters and sores on other parts of the body
• Enlarged lymph nodes in the arm

High fever (temperature over 101°F) and confusion/lack of consciousness may indicate serious infection/progression of the disease.

Management / Interventions

Although, there is no known cure of the disease and the disease is a self-limiting one, therefore, it usually resolve within two to three weeks. However, certain measures may be undertaken to improve the symptoms. These include;

• Topical anaesthetics to reduce pain and itching
• Antiviral medications
• Analgesics to reduce pain and fever (if present)
• Electrotherapy

Not much research work has been done on Physiotherapy and Whitlow.

Complications

Untreated whitlow can come with serious complications which include;

• Encephalitis
• Meningitis
• Tenosynovitis
• Pain and discomfort
• Spread of infection
• Skin ulcerations and infections