acyclovir and Paronychia

Isotretinoin is an extremely valuable drug that is occasionally associated with well-known mucocutaneous side-effects, including cheilitis, retinoid dermatitis, palmoplantar desquamation, and photosensitivity. Paronychia has been reported rarely: only two prior cases of herpes simplex infections associated with isotretinoin have been previously reported. We present the first known case of herpetic paronychia occurring in an atopic patient while on isotretinoin therapy for acne.

Topics: Acne Vulgaris; Acyclovir; Adolescent; Antiviral Agents; Dermatologic Agents; Herpes Simplex; Humans; Isotretinoin; Male; Paronychia

This paper provides a case report and review of the literature of the presentation of multiple herpetic whitlows with primary herpetic gingivostomatitis. The management of the condition is discussed.

Topics: Acyclovir; Adult; Humans; Male; Paronychia; Stomatitis, Herpetic; Virus Shedding

Herpes simplex infection of the hand is often falsely diagnosed as a pyogenic paronychia or felon and treated as such, because the clinical picture is not known and pathogen isolation is difficult. However, the surgical treatment of herpes digitalis is contraindicated, since it promotes the development of superinfections and triggers recurrence. The pathogen can be isolated in cell cultures prepared from the vesicle contents or a smear from the vesicle base. Serological antibody testing is unreliable. Topical application of Acyclovir cream (Zovirax) is the treatment of choice.

Topics: Acyclovir; Administration, Topical; Adult; Dermatitis; Diagnosis, Differential; Herpes Simplex; Humans; Male; Paronychia; Recurrence

The herpetic whitlow should be treated nonoperatively. However, a difficult therapeutic dilemma occurs when a whitlow is seen with an established bacterial abscess. We report a case of an adult whose first herpetic whitlow was complicated by secondary periungual abscesses that progressed despite intravenous antimicrobial therapy. Surgical drainage of these periungual abscesses was successfully done in conjunction with intravenous acyclovir with no adverse effects.

Topics: Abscess; Acyclovir; Adult; Cephalosporins; Combined Modality Therapy; Drainage; Fingers; Herpes Simplex; Humans; Male; Paronychia; Staphylococcal Infections

Herpetic whitlow is a herpes infection of the digits of the hand, first described in 1909, caused by either herpes simplex virus type 1 or type 2. It was not until 1959 that herpetic whitlow was reported to occur in health care professionals. Nurse anesthetists are among the many health care professionals considered to be at high risk for acquiring herpetic whitlow, making it an occupational, but preventable, disease. After an initial infection, the virus invades the nerve tissue supplying the affected area, thus creating a reservoir for the virus to remain latent until reactivated. The recurrence of herpetic whitlow suggests that the infection persists for life. Pain, tingling and burning of the distal phalanx are the initial symptoms. Swelling and vesicles on an erythematous base follow. The infection is self-limiting, usually resolving in about three weeks. Primary infections are very inflammatory and persistent. Diagnosis can be made clinically and confirmed by many laboratory tests. Early recognition is most important, and treatment is symptomatic. The drug acyclovir has proven to be an effective chemotherapeutic agent for suppressive therapy.

Topics: Acyclovir; Herpes Simplex; Humans; Nurse Anesthetists; Occupational Diseases; Paronychia

Topics: Acyclovir; Antiviral Agents; Herpes Simplex; Humans; Occupational Diseases; Paronychia