acyclovir and Foot-Dermatoses

We report a case of indolent herpetic whitlow of the toe occurring in an elderly male patient with poorly controlled diabetes mellitus. In this case, the mechanism of transmission was not clear, although he was in a habit of taking a hot spring bath. This patient's symptoms were unusual for herpes simplex; he had no pain in the presence of diabetic neuropathy. The standard therapeutic dose of acyclovir was not effective in suppressing the lesions, and a higher dose was required to induce complete healing.

Topics: Acyclovir; Aged; Antiviral Agents; Cellulitis; Diabetic Foot; Diabetic Neuropathies; Foot Dermatoses; Herpes Simplex; Herpesvirus 1, Human; Humans; Hypesthesia; Male; Toes

Herpetic whitlow of the toe is a common infection in an uncommon location, leading it to be frequently misdiagnosed; however, as the virus responds well to conservative management or antivirals alone, proper identification is necessary to prevent unnecessary interventions. We present a case of herpetic whitlow of the toe with an unusually ominous appearance in a previously healthy and otherwise well-appearing child. This case illustrates the spectrum of herpetic whitlow's clinical presentations and enourages consideration of the disease even for atypical location and severity.

Topics: Acyclovir; Antiviral Agents; Cellulitis; Child, Preschool; Foot Dermatoses; Herpes Simplex; Herpesvirus 1, Human; Humans; Male; Toes

Topics: Acyclovir; Antineoplastic Combined Chemotherapy Protocols; Antiviral Agents; Foot Dermatoses; Herpes Zoster; Herpesvirus 3, Human; Humans; Immunocompromised Host; Lymphoma, B-Cell, Marginal Zone; Male; Middle Aged; Predictive Value of Tests; Risk Factors; Skin; Treatment Outcome; Valacyclovir; Valine; Virus Activation

A 9-month-old baby girl presented multiple times with an erythematous, papular and pustular big toe in an otherwise healthy infant. A diagnosis of cellulitis was made and she was started on oral antibiotics, and bacterial swabs were taken. After 2 weeks of worsening appearance she was admitted for intravenous antibiotics. Inflammatory markers remained normal and viral swabs were taken. No improvement was seen after 2 days and she was referred for orthopaedic and dermatological opinions. The orthopaedic team recommended debridement whereas the dermatologist suspected a primary herpetic whitlow and recommended intravenous acyclovir in addition to intravenous antibiotics. A viral swab for Herpes simplex virus type 1 (HSV1) was positive by PCR on day 3. The toe continued to improve clinically and the patient received 21 days of acyclovir in total. 27 days after discharge the infection relapsed. She was treated with a further 14 days of oral acyclovir and recovered completely.

Topics: Acyclovir; Administration, Oral; Antiviral Agents; Diagnosis, Differential; DNA, Viral; Female; Foot Dermatoses; Herpes Simplex; Herpesvirus 1, Human; Humans; Infant; Polymerase Chain Reaction; Recurrence; Toes

Topics: Acyclovir; Adult; Female; Foot Dermatoses; Humans; Male; Middle Aged; Warts

Topics: Acyclovir; Adolescent; Antiviral Agents; Female; Foot Dermatoses; Guanine; Humans; Warts