Diagnosed with herpes whitlow

[som1special]

I contracted genital herpes about 15 years ago.  I had a hard time dealing with it and had continuous outbreaks for awhile.  I eventually came to accept having herpes and to not be down on myself.  Several years after that I was in a relationship with someone who had herpes.  I used to be very active in herpes support groups online so consequently I learned alot about herpes.  One thing that I had read and heard from other people is that once you have herpes you can't contract it again.  Now I don't know if I am HSV1 or HSV2.  I never had the blood tests done.  After a few years in my relationship my herpes OBs moved to the anal/rectal area.  I believe that I actually had a primary outbreak due to contracting my partner's strain of the virus.  I read over and over that that just doesn't happen but my outbreak was so different and so painful.  And took months to actually heal.  I would have an outbreak and it would heal and a new one start all over again.  It took a few years and the obs got less frequent and painful.  I still have about 3 or so a year.  
A couple of weeks before my gallbladder surgery I had an ob and it was much worse than it had ever been and I believe it was from the stress of the upcoming surgery.  I told the surgeon about it and she told me I needed to clear it up before I had surgery because it would really make the ob much worse,  I asked her for a prescription for 5% zovriax cream which when I applied it to my ob I was extremely excited and pleased that it calmed down the blisters in about an hour.  I had used the lower dose cream years ago and I don't recall it working like that.  
Fast forward to exactly a week after my gallbladder surgery and I wake up with 3 closed blisters on the bottom of my right palm.  I noticed that it was kinda sore and itchy.  I also had had an allergic reaction to the sticky tape that is used to do an EKG.  My surgeon remarked on how allergic I was to it.  At that point I showed her my hand but she didn't say anything about it.  I woke up the next morning and there were 2 additional blisters on my palm.  And it was getting increasingly sore and itchy.  The next morning (Saturday) I woke up and my hand was sore and red.  It was so sore that it really hurt to use my thumb because it pushed into the blister area.  At this point I decided to go to the local acute care facility.  The doctor diagnosed my with herpes whitlow.  He wanted to prescribe meds and I told him that I had tried all three and that they make my stomach hurt.  I also told him that I am always very careful when I touch an ob to was my hands really well. I have read that herpes whitlow is not that common.  I didn't have a sore or open wound on my hands at all.  According to what I have read, it doesn't make any sense that I would have transferred the virus through self inoculation since the skin is much tougher and I am super vigilant about washing my hands after touching my ob.  
On Sunday, my blisters were starting to merge together and not quite as sore by late that evening.  Today it is feeling a bit better but still sore.  At least now I can type on my computer because some of the soreness is going away.  The area is still sore and very red.  
My question is should I go get this checked by a dermatologist? Can they run tests on it?  I already have herpes so that would show up in an antibodies test.  
I have spent a good deal of time on the internet researching this since I went to the acute care facility.  Some information says that a doctor can diagnose herpes by just looking at it, some information says that it needs to be cultured.  I did ask the doctor for a test and he said by the time the results came back that my outbreak would be gone.  I should have insisted but to tell you the truth I was stunned by the diagnosis.  I was trying to figure out how I could have contracted herpes again.  
Sorry to be so long winded.  I just wanted to give as much information as possible.

Any help and replies would deeply appreciated.  
Thank you

[gracefromHHP]

those freakin' copays can kill you!  They are fine if you only see a doctor once a year for a check up but if you actually have to use your insurance, before you know it, you are paying out far too much money towards your appointments....sigh.     Ok, off my soap box....lol.  

next time you start to get a recurrence of your herpes, start oral antivirals at the very first sign of a possible recurrence. You often can head off a full blown ob by doing that.  We've found over the years that hitting it hard and fast gets you the best results.  

definitely ask for latex testing too.  

grace

[som1special]

Hi Grace,

Thanks so much for your timely reply, I really appreciate it!

I wished I had pushed harder for a test but the doctor didn't seem like he really wanted to be any more involved than just writing a prescription.  I am thinking about putting in a call to my GP in the morning and see if I can get in to see him.  I just hate to keep paying co-pays when I just got through paying for all the testing for my gallbladder.  Not to mention the costs of visits for specialists.  And I visited two surgeons before I picked one to perform my surgery.  And now I have to pay my portion for the surgery.  

Before I received your reply I had started to think that possibly what is going on is some sort of infection.   And your post helped me to confirm that possibility. I have three places on my chest that are itchy and one place is getting sore.  I seem to remember shortly after the surgery that there were places on my chest that were irritated and itchy and I pretty much guessed that I had a reaction to the EKG patches.  And my surgeon confirmed that last Thursday when I went to see her.  The interesting thing is that when I came home from the hospital I put on a v neck pajama top.  It just so happens that the v neck exposed the irritation on my chest.  And I remember laying my hand on my chest as I rested and slept after the surgery.  I remember that I didn't want my hand resting on my tummy because it was very tender.  Here is the kicker of all of this......where I rest my hand is right where the irritation is on my chest, and the place where i have the blisters on my hand is where my hand would have laid on my bare chest.  So I am wondering if in fact what might have happened is that I scratched at the irritation on my chest and it got some sort of staph infection and I spread it to my hand.

My hand is still very sore and painful and red.  No signs of eruption of the blisters and the blisters have somewhat flattened out.  Now I know for a fact that herpes can be very painful but I am not sure the pain and soreness that I am feeling is herpes.  I find it so hard to believe that I would have contracted or self inoculated myself with herpes.

Thanks for the info about the side affects of the herpes antivirals.  I don't believe I have ever been told that it takes a few weeks for the abdominal pain to get better.  I will certainly keep that in mind.  I know I have tried taking the meds in past and it didn't seem like they actually worked well enough to stomach the pain.  

On another note, I have to tell you that I have tried several things on my tailbone area where my herpes likes to ob now and most never really worked very well.  The Zovirax cream was so amazing.  I had about an inch long row of blisters on each crack of my buttocks, which is the worst blistering I have ever had.  Most of the time my ob is like tiny slits that turn into tiny blisters.  I had endured this blistering for two days and it was very itchy and stingy and sore.  Within an hour of applying the Zovirax cream it had calmed down 50%!  And I continued applying it every few hours and the next day it was almost completely gone. In fact I was able to have my gallbladder surgery sooner than I thought I would because my ob cleared up much faster than normal.  I'll tell ya.....it feels like when it comes to herpes, my experience has not been in what you would call the normal range.  

Any more ideas? Comments??

Thanks again

[gracefromHHP]

without a lesion culture to confirm, no way to know if this really is whitlow or not. You can get whitlow when you've had hsv2 previously but the risk of such is very low, especially on the palms of the hands.  At this point it's too late for an accurate lesion culture.  So many things this could be and it is too bad the provider didn't do the culture to confirm so you had better answers. you were recently in the hospital and could've had a reaction to latex or even contracted an infection.  

zovirax ointment really does nothing for genital herpes recurrences - we never recommend it for genital herpes. odds are it's the base ointment in the cream helping you more than the antiviral in it was.

You might've gotten a 2nd infection of hsv2 from your partner  but no reason for it to last that long  ( in studies that looked at this, even in folks who have multiple strains of hsv2, they don't have "worse" infections or more recurrences or anything of that sort ). it really sounds like you really have more than just hsv2 going on ( and I'd confirm that you have hsv2 at all to be honest though if you didn't originally, having had a hsv2+ partner and taking no precautions might've given it to you too ).  herpes lesions won't take that long to heal even without treatment so following up on all of this is worthwhile.  You very well might have something else dermatological going on ( perhaps even a latex allergy considering your reaction to the ekg patches ) , an allergy to adhesives or even had something else infectious going on at the same time.  

abdominal pain is a side effect of the herpes antivirals.  it's to be expected to be honest.  For recurrences you can try 800mg acyclovir 3x/day for 2 days , make sure you take your doses with full meals and hope that the 2 day dose causes you pain for the least amount of time. if you should decide to try the antivirals suppressively, usually the abdominal pain gets better in a few weeks.  

This really sounds like it's worth more follow up to get better answers. keep asking questions!

grace