Key result
Acyclovir treatment led to a remarkable clinical response in an immunocompromised patient with an atypical herpetic whitlow initially misdiagnosed as squamous cell carcinoma.
Case Report (n=1)
Highlights the need for high clinical suspicion of herpetic whitlow in immunocompromised patients presenting with atypical recalcitrant hand ulcers to avoid misdiagnosis.
May prompt antiviral consideration for atypical hand ulcers in immunocompromised patients; case reports leave diagnostic algorithms open for validation.
This is a case report to highlight the atypical presentation of hand ulcers caused by herpes simplex virus (HSV) in immunocompromised patients. We report a case of a 43-year-old right-handed female who developed a nonhealing and progressive ulcer involving the left middle finger and extending to the palm for which she was referred to our facility. Initial clinical diagnosis following examination was squamous cell carcinoma. However, carefully observed similar new lesions she developed while being investigated was in favour of HSV infection. She had remarkable response on acyclovir which substantiated the diagnosis. Awareness and a high index of clinical suspicion are required of physicians who may come across similar lesions.
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Nwakire et al. (2015) conducted a case report in Herpetic whitlow (finger ulcer) in HIV (n=1). Acyclovir was evaluated on Clinical response. Acyclovir treatment led to a remarkable clinical response in an immunocompromised patient with an atypical herpetic whitlow initially misdiagnosed as squamous cell carcinoma.
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