I am a 49 year old male. I developed herpetic whitlow of the proximal phalanges of the left middle finger. There was no complications with bacterial super infection.
I had slightly pricked the side of my middle finger with a staple and the wound seemed to be healed over. A day or two later my partner and I had sexual relations during which I used my fingers for stimulation of my partner. She had developed a primary case of HSV2 in the perineum some 18 years ago. She had no current signs and has not developed any. Her last outbreak was almost 10 years ago.
The staple wound seemed to resolve, leaving behind only a tiny area of cellulitis. About 6 days later, the wound developed a larger area of redness, and I cleaned it with soap and water, applied some antibiotic cream, and covered it with a band aid. The following day when I changed the bandaid the redness had spread distally in a narrow band.
By that evening the typical vesicles began to develop. I was aware of herpetic whitlow and recognized the signs. I applied Abreva and changed it and the bandaid three times a day. I did not apply it more often due to the fragility of the vesicles.
After two days the infection covered the area on the phalanx from knuckle to knuckle and approximately 1/3 of the diameter of the finger, but did not seem to spreading beyond this point. I continued to apply Abreva and clean the area three times per day, carefully cleaning my hands after each dressing change. I also wore a cotton glove between dressing changes.
By the fourth day, the lesion was red and taut, but no longer particularly painful. There was an area of open skin about 15mm x 4mm. Primary drainage had ceased. Applications of hydrogen peroxide did not show any significant super infection. However, the area covered by the lesion and cellulitis had not changed.
At that time I visited my primary care physician. He confirmed the diagnosis and prescribed topical acyclovir. He also pointed out that Abreva is useful only against HSV1 infections and this was almost certainly HSV2, therefore it would have been advisable to seek medical attention earlier. The area began to scab over about a week later, but remained red and taut for another week.
After about 3.5 weeks the scab had detached and the lesion was smooth, although still quite red for a radius about about double the size of the lesion proper. After 5 weeks the redness has faded considerably, though not completely. I continue to cover it with a bandaid and will probably continue to do so until the skin returns to a normal color. I intend to avoid contact with any mucous membrane or my genitalia for at least two to three weeks subsequent to complete visual resolution.
I experienced some malaise, fatigue, and nausea the day previous to emergence of the lesion, and for two days thereafter. The lesion was not extremely painful, probably due to the location on the proximal phalanx, instead of the common location at the distal phalanx, where it can irritate the pulp underlying the fingernail.
The primary difficulties of management were the regular and somewhat risky dressing changes, and the concern about when I could resume free use of the digit with near-zero risk.
I would recommend that anyone developing identifiable symptoms seek medical treatment immediately so as to acquire topical acyclovir as soon as possible.
Read more true stories here
