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Herpetic Whitlow..HELP!!
Mar 12, 2002

I have had HSV1 on the thumb of my left hand for 5 years, I think? It is now starting to spread to the palm of my hand. However, this was only recently diagnosed. I had 7 cultures during an active outbreak and they all came back negative. I had 2 biopsies. The first one came back "Dyshidrosis". The second came back positive for HSV. I do have HSV1 orally and I use to bite my nails. The doctor said this is probably how this happened. My question to you, is...because there was blood taken along with the second biopsy, could the biopsy have captured the virus in my blood rather than the skin taken? Could this be an inaccurate diagnosis? I have been on Valtrex for the past 8 months and have still had 3 outbreaks during that time. Any help you can offer would be greatly appreciated.

Response from Dr. Feinberg

Herpetic whitlow is a difficult problem, because it is so persistent and recurrent. Make sure you are on an adequate dose of Valacyclcovir (Valtrex), at least 500 mg twice a day. It is possible to have recurrence despite chronic suppressive therapy (twice a day treatment to try to prevent recurrences), but this should be much less often than when the whitlow is untreated.

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