Herpetic Whitlow

[humeshat]

I’m worried that I might have contracted herpetic whitlow, even though I don’t have any symptoms.
First though, some background: I’ve had HSV-1 in the genital area for the last two years. Seeing as the incidence of HSV-1 shedding in the genital area is far less than HSV-2 shedding, it would seem that I’m already at a lower risk for contracted HW than many others. However, my main concern is that even after a primary episode, it takes a few months to build up all the antibodies the body needs to make autoinoculation unlikely. In the months after my primary infection (at the time I was unaware that my hand could get infected), I masturbated roughly once a day. Thankfully, every time I did, I washed my hands immediately after, but I’m still concerned that I might have contracted it during asymptomatic shedding. My only outbreak was during the primary infection, so I’ve never masturbated with lesions. Despite this, it seems likely that my hands came into contact with some asymptomatic shedding at least a couple of times during these months. Also, I have very dry skin, and almost always have a hangnail or some other type of abrasion on my fingertips.

However, seeing as I washed my hands afterward (and that there were at least some antibodies established), how likely do you think it is I might have contracted whitlow?

I’ve been relieved to see you say on this forum that herpetic whitlow doesn’t shed asymptomatically because the skin on the finger is too thick. This is awesome news, but what about the skin around the fingernail? That seems to be pretty thin.

Thanks so much

[Terri Warren]

I have never heard of nor seen a case of asymptomatic herpes whitlow. By definition, it is symptomatic. I really don’t think this is something you would be worried about at all! Your hands could have come in contact with asymptomatic shedding, yes, but the skin of the hand is too thick for virus to penetrate without some break in the skin. And if you had a break in the skin and contracted HSV as whitlow, you would have had symptoms.

Terri

[humeshat]

Thanks so much for your response! This is a relief to hear. One quick follow-up: Why is it that whitlow is always symptomatic, whereas on other parts of the body herpes will sometimes never show any symptoms? Does it have something to do with the fact that herpetic whitlow is on the fingers? This might seem like a pedantic question, but I’m entering into a relationship and just want to make sure I’m as informed as possible.

[humeshat]

Also, to give some context:
I’m a medical student and have been poring over academic journals trying to find an explanation for why herpetic whitlow doesn’t shed asymptomatically. So far I haven’t found anything that gives a verdict one way or the other, so if you have any papers off the top of your head you could direct me to it would really put my mind at ease.

Sorry if I sound neurotic! It’s just that I’m entering into a relationship with someone who I deeply care about and want to be as informed as possible about the risks.

[Terri Warren]

Asymptomatic shedding only occurs from areas of the body where the skin or tissue is very thin, so the virus can come to the surface of that skin or tissue and be released from the body. The reason fingers don’t shed virus is because the skin is way too thick for virus to come to the surface without a lesion.

terri

[humeshat]

Hi Terri,

Thanks so much for your response. Just so you know, I purchased another round of follow-up questions.

I’m so happy to hear this! If the skin around my fingernail is too thick to shed asymptomatically, can the same be said for my pubic area (not my penis or testicles, but the area around there?). Also, would you be willing to direct me to some of the papers that have been published on the topic of skin being too thick for virus to shed asymptomatically? I trust your advice, but would like to further educate myself on the topic. Moreover, my physician says that herpetic whitlow can shed asymptomatically, and it would be nice to show him something that suggests otherwise. I hope this is an okay thing to request!

Thanks for everything you do

[Terri Warren]

I am not aware of any papers addressing this topic – it is simply a medical fact. you can certainly ask but I have no papers to refer to.I suspect if you research the concept of asymptomatic viral shedding of HSV you might find something.

Terri

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