Herpetic Whitlow and Shingles Vaccine

[DissolvedO2]

Hi – I have herpetic whitlow in my right arm (pinkie finger). I contracted when applying medicine to a cold-sore accidentally got into my cuticle while wiping off my finger (prior to washing hands). Anyway, it has been mild, but anxiety-provoking with frequent nerve pain in my arm and fingers swelling/tingling. I received the shingles vaccine two weeks ago in that arm (should have spoken up and used the other arm, which received the flu shot). Since the shingles vaccine, my right arm has been incredibly painful, I had several sub-cutaneous blisters on my middle finger and one on the outside of my palm (near the base of my pinkie finger). I upped my Valtrex dose to 1000 mg 2X per day for two weeks, when the symptoms subsided. Two days ago I lowered my valtrex dose back to 500 mg 2X per day. Today I noticed tingling above my right knee (I should say that I also have genital herpes). I’m wondering whether I may have transmitted herpes to my leg from my hand by applying lotion, or whether this is shingles or herpes migrating. Care to take a guess? Should I up my Valtrex dose again? I’m truly sick of living with this virus and would love your thoughts on what I might do to better care for myself. Thanks so much for providing this service and sharing your insights.

[Terri Warren]

So how were you diagnosed with herpetic whitlow on your pinkie finger? And how long ago was that?
Were you taking antiviral medicine when you got the shingles vaccine?

Terri

[DissolvedO2]

I was self-diagnosed with the pinkie outbreak (went to the doctor and both of us didn’t want to sample the lesion). But I recall the incident of putting zovirax on a cold-sore and accidentally getting the medicine into my cuticle while I was wiping it off, prior to washing my hands. My pinkie finger had another mild outbreak a year later, neither of which appeared to “break the skin.” Both outbreaks appeared as small, single “vesicles” below the skin surface, right next to the nail bed. I was diagnosed 4 years ago with the pinkie herpes, I’ve had oral herpes for approximately 35 years and genital for about 25 years (I have both HSV 1 and 2, though I don’t know which is where). And, yes, I take 500 mg valtrex twice a day; I was taking it when I got the shingles vaccine. Thanks for any thoughts you might offer.

[Terri Warren]

The situation you describe as when you think you got herpes on the finger really doesn’t fit well with how this all goes. Once you have herpes in one location it is extremely unlikely you would get it in a new location on your body. Without a swab test that is positive from a lesion on your finger, I would be skeptical that that is what is going on.

If you are taking antiviral therapy when you get the shingles vaccine, the vaccine is no where near as effective. The shingles vaccine is a live vaccine and the antiviral therapy will kill the virus in the vaccine, thus making it far less effective. A person should not take antiviral therapy for 5 days prior to getting the vaccine and for two weeks after.

terri

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