Hands
Tor Wo Chiu in Stone’s Plastic Surgery Facts, 2018
Herpetic whitlow – this is a herpes simplex virus (HSV) vesicular eruption in the fingertip that is typically preceded by burning-type pain the day before. It may resemble a felon, but the pulp itself should not be tense and the vesicles are filled with clear fluid (sometimes cloudy, may coalesce). These should only be incised if a secondary bacterial abscess has developed; otherwise, the open wound is at risk of super-infection. A vesicle may be deroofed for viral culture or a Tzanck smear (quicker and cheaper). It is usually self-limiting (7–10 days), but topical 5% acyclovir may be used in severe infections to shorten the disease course. There is a 20% risk of reactivation usually resulting in milder disease; oral acyclovir taken during the prodrome may abort recurrence. It is infectious until epithelialisation is complete.
Herpetic whitlow
Alisa McQueen, S. Margaret Paik in Pediatric Emergency Medicine: Illustrated Clinical Cases, 2018
This patient has herpetic whitlow, a type of herpes simplex virus (HSV) infection that typically affects the thumb or fingers. The primary route of exposure is direct inoculation of the digits from herpes lesions or infected oral secretions (American Academy of Pediatrics, 2015). Thumb-sucking in toddlers with primary oral herpes infection may lead to autoinoculation. Medical and dental professionals may acquire infection through exposure to infected oral secretions when proper contact precautions (e.g. gloves) are not used. Most infections in children are caused by HSV-1, whereas persons in their 20s and 30s may be infected by HSV-2 through exposure to genital lesions (Szinnai et al., 2001).
Nail in dermatological diseases
Archana Singal, Shekhar Neema, Piyush Kumar in Nail Disorders, 2019
Other pemphigus variants exhibit nail affection. Nail shedding, in addition to yellowish nail discoloration, onychorrhexis, and onycholysis, onychomadesis, pterygium, subungual hyperkeratosis, and onychogryphosis may occur in Brazilian pemphigus (fogo selvagem).40 Vegetating pemphigus of Hallopeau show pustules with onychoatrophy.3 Differential diagnosis includes herpetic whitlow.38 The diagnosis of pemphigus can be made by histological identification and/or by direct immunofluorescence testing. The prognosis of nail changes in PV is generally good, with successful resolution of the nail changes with treatment.38
A brief guide to pustular psoriasis for primary care providers
Published in Postgraduate Medicine, 2021
Jeffrey J. Crowley, David M. Pariser, Paul S. Yamauchi
For localized sub-types of pustular psoriasis, the main differential diagnoses include PPP and ACH, pompholyx (also called dyshidrotic eczema, or acute and recurrent vesicular hand dermatitis), and nail infection (for ACH). Pompholyx is a chronic dermatitis characterized by the appearance of clusters of vesicles (clear blisters) on the palms and soles, accompanied by erythema and intense pruritus, and pustules may be present [39]. It is rarely difficult to distinguish between PPP and pompholyx, although discriminatory histopathologic features have been described [40]. Nail infection may be investigated by testing the pustule material (e.g. gram stain for possible bacterial infection; potassium hydroxide test for possible fungal infection; polymerase chain reaction testing for possible herpetic whitlow [41]).
Seroprevalence of herpes simplex virus types 1 and 2 in Nigeria: a systematic review and meta-analyses
Published in Pathogens and Global Health, 2019
Eleazar E. Reward, Sophia O. Muo, Ibuchukwu N. A. Orabueze, Anthony C. Ike
Herpes simplex virus types 1 and 2 are lifelong infections [1]. Following initial infection, lifetime latency is established within neural ganglions from which viruses can be reactivated periodically [2]. Globally, infections caused by herpes simplex virus types 1 and 2 are amongst the most common human viral infections. The transmission of HSV-2 is mainly through sexual means, while HSV-1 is transmitted non-sexually during infancy [2]. However, there is an increasing proportion of genital herpes infections caused by HSV-1 in the developed world. This is probably due to changes in sexual behavior, with oral-genital sex becoming very common [3]. Both types of the virus cause sub-clinical infection and thus many of those infected are oblivious of their infection status. When the patient becomes symptomatic however, there is a presence of episodic ulcerative lesions at the site of infection [1]. Globally, HSV-2 is also the most common sexually transmitted disease (STD) [4], and the most widespread cause of Genital Ulcer Disease (GUD) [5]. HSV-1 and HSV-2 infections sometimes lead to serious complications in infected individuals. These complications range from fatality in infants infected perinatally to corneal blindness, herpetic whitlow, gingivostomatitis, aseptic meningitis and encephalitis amongst others [6,7]. HSV also has a significant interaction with HIV, as HSV-2 infection quadruples the risk of transmitting HIV infection and also increases 2- to 3- fold the chances of acquiring the disease [1]. According to meta-analysis, HSV-2 seropositivity is associated with HIV acquisition risk ratio of 2.7 in men and 3.1 in women [8].
Exposure to occupational hazards among bakers and their coping mechanisms in Ghana
Published in Cogent Medicine, 2020
Winifred Serwaa Bonsu, Dina Adei, Williams Agyemang-Duah
The study revealed that the specific biological hazards the participants were exposed to include mosquitoes, insects, and rodents because ingredients such as flour, wheat, margarine, and sugar were kept in their working room. Malaria was noted as the predominant effect of biological hazard participants were exposed to. Besides the biological hazards, the study reported that the participants were exposed to stress (workload), verbal abuse and poor interpersonal relationship as the types of psychosocial hazards. These psychological hazards resulted in injuries, low productivity, absenteeism and poor concentration at work. Employers refuse to increase their staff because the informal sector is geared towards profit maximisation (De Bruin & Taylor, 2005). This contributes to a stressful and an unfriendly working environment. These psychosocial hazards affect workers and their families as well as their jobs since sickness is related to loss of productivity and hence low incomes. Besides, stress reduces workers’ productivity, which causes an economic loss of approximately 4–5 percent of the Gross National Product of many countries (Greenlund et al., 1995). These also have physical, mental, social and health implications on bakers (Greenlund et al., 1995). In this study, participants were exposed to chemical hazards. Bakers especially pan cleaners used sodium hydroxide, bleach and other chemicals for cleaning the baking environment, which cause skin infection and irritation to the eye (Aguwa & Arinze-Onyia Sussan, 2014; Arrandale et al., 2013). Due to the chemicals used in the preparation of the local soap “Azuma blow” cleaners, develop whitlow and parts of their skin peel off.