title: Multiple herpetic whitlow lesions in a patient with chronic lymphocytic leukemia.
abstract: Herpetic whitlow, a herpes simplex virus infection involving the digits, most commonly presents as a vesicular eruption involving a single digit. Diagnosis of herpetic whitlow can usually be made with the history of exposure, the characteristic vesicular eruption, and a positive Tzank smear and/or viral culture. We describe a case of herpetic whitlow in a patient finishing 6 cycles of chemotherapy for refractory chronic lymphocytic leukemia that presented with a bilateral, multi-digit, crusted eruption of the hands. This is an illustrative case of an immunocompromised host status altering appearance and course of cutaneous disease such that the history and physical exam alone may not help in diagnosing atypical presentations of herpetic infections. This case underscores the necessity for clinico-histopathologic correlation.
authors.affiliation: Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
authors.forename: Edward
authors.initials: E
authors.lastname: Smith
authors.forename: James R
authors.initials: JR
authors.lastname: Hallman
authors.forename: Asha
authors.initials: A
authors.lastname: Pardasani
authors.forename: Amy
authors.initials: A
authors.lastname: McMichael
mesh_terms: D000212:Acyclovir / Q000627:therapeutic use; D000956:Antigens, Viral / Q000032:analysis; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D004890:Erythema / Q000821:virology*; D005385:Fingers; D006561:Herpes Simplex / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D006801:Humans; D016867:Immunocompromised Host; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D018139:Simplexvirus / Q000276:immunology; D012867:Skin / Q000473:pathology / Q000821:virology; D012883:Skin Ulcer / Q000821:virology*
chemical_list: D000956:Antigens, Viral; D000212:Acyclovir