Atypical paronychia: don't forget herpesvirus.

Paronychia is usually caused by bacterial infections. Herpetic whitlow is an acute infection of the fingers or toes caused by herpes simplex viruses and it typically presents with vesicles. We report the case of a 78-year-old woman with gingivostomatitis and atypical paronychia in several fingers without blisters.

Herpes Simplex Virus Type 1 infection: overview on relevant clinico-pathological features.

Herpes Simplex Virus Type 1 (HSV-1) is a nuclear replicating enveloped virus, usually acquired through direct contact with infected lesions or body fluids (typically saliva). The prevalence of HSV-1 infection increases progressively from childhood, the seroprevalence being inversely related to socioeconomic background. Primary HSV-1 infections in children are either asymptomatic or following an incubation period of about 1 week gives rise to mucocutaneous vesicular eruptions. Herpetic gingivostomatitis typically affects the tongue, lips, gingival, buccal mucosa and the hard and soft palate. Most primary oro-facial HSV infection is caused by HSV-1, infection by HSV-2 is increasingly common. Recurrent infections, which occur at variable intervals, typically give rise to vesiculo-ulcerative lesions at mucocutaneous junctions particularly the lips (herpes labialis). Recurrent HSV-1 infection within the mouth is uncommon in otherwise healthy patients, although in immunocompromised patients, recurrent infection can be more extensive and/or aggressive. The diagnosis of common herpetic infection can usually be based upon the clinical history and presenting features. Confirmatory laboratory diagnosis is, however, required when patients are, or may be, immunocompromised.

Bowen disease of the nail bed presenting as longitudinal melanonychia: detection of human papillomavirus type 56 DNA.

A case of Bowen disease (BD) presenting as longitudinal melanonychia (LM) on the right third fingernail of a 25-year-old African American man is described. Findings from the histopathologic examination revealed full-thickness epidermal atypia, hypergranulosis, and koilocytic changes. Human papillomavirus (HPV) type 56 was identified by polymerase chain reaction. To the best of our knowledge, we describe the first case of BD of the nail unit in which HPV-56 DNA has been identified.

Herpetic whitlow during isotretinoin therapy.

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.

[Herpes simplex virus infection of the hand]. / Herpes-simplex-Virus-Infektion der Hand.

HISTORY AND CLINICAL FINDINGS: An 18-month-old infant was admitted for a suspected bacterial hand infection that had developed within 2 days. Examination demonstrated multiple vesicles with erythema involving the dorso-ulnar aspect of the thumb. The infant was in a good condition, had no constitutional symptoms and a history of gingivo-stomatitis 6 months ago. EXAMINATIONS: The diagnosis of herpes simplex infection was based on the history and the clinical findings. TREATMENT AND COURSE: Treatment consisted of dry dressings, and over the next 3 weeks, the lesion healed without scarring. CONCLUSION: Herpes simplex virus infection of the hand is uncommon, often misdiagnosed and therefore overtreated or inadequately treated. Usually the diagnosis can be made from history and clinical findings. In general, the infection is managed conservatively. Treatment by incision and drainage is contraindicated.

Primary herpetic gingivostomatitis with multiple herpetic whitlows.

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.