Management of Resistant Herpetic Whitlow: A Case of Recurrent Herpetic Whitlow Resistant to Standard Therapy

Introduction: Herpetic whitlow, due to herpes simplex virus (HSV) type 1 or 2, typically presents with vesicles that may coalesce into bullae. Herpetic whitlow often resolves without intervention but can be treated with antiviral medications. Case Presentation: Herein is a report of a 68-year-old fe...

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Bibliographic Details
Published in:Case reports in dermatology Vol. 17; no. 1; pp. 224 - 230
Main Authors: Singal, Amit, Wong, Ting Ting, Lipner, Shari R.
Format: Journal Article
Language:English
Published: Switzerland S. Karger AG 28.05.2025
Subjects:
Single Case
Herpetic whitlow
Infectious disease
Immunosuppression
Finger herpes
Digital herpes simplex
ISSN:1662-6567, 1662-6567
Online Access:Get full text
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Summary:Introduction: Herpetic whitlow, due to herpes simplex virus (HSV) type 1 or 2, typically presents with vesicles that may coalesce into bullae. Herpetic whitlow often resolves without intervention but can be treated with antiviral medications. Case Presentation: Herein is a report of a 68-year-old female patient with a history of well-controlled human immunodeficiency virus (HIV) infection and a 4-year history of recurrent HSV-2 herpes genitalis who failed multiple trials of standard antiviral therapy clinically confirming a case of resistant HSV-2 infection, with recurrent tender lesions on her digits. Physical examination showed bullae involving the nail folds of her right thumb and left index finger. Initial PCR was negative for HSV-1 and HSV-2, but repeat PCR was positive for HSV-2. Treatment with foscarnet resulted in clinical improvement of both herpetic whitlow and herpes genitalis. Conclusion: Though herpetic whitlow typically resolves without intervention, a case is described of recurrent lesions in an HIV-positive patient unresponsive to multiple first-line antiviral treatment regimens and an interdisciplinary approach to treatment in a challenging case.
Bibliography:ObjectType-Case Study-2
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ISSN:1662-6567
1662-6567
DOI:10.1159/000546664