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Dr. Nair
Dr. Nair, Dermatologist
Category: Dermatology
Satisfied Customers: 9133
Experience:  MBBS, MD (Dermatology, Venereology & Leprology)
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Ok. I'm trying to nail down a diagnosis here. I am a 28

Customer Question

Ok. I'm trying to nail down a diagnosis here. I am a 28 year old white male. Since I was 19, I've had an infection of herpes whitlow on the thumb where I have an outbreak about once a year that results in horrible pain through my entire forearm. Recently, I took a HSV 1 and 2 blood test because they have not been included in my other STI tests and it came back positive for HSV 2 with > 5 H - could these antibodies have formed long ago when I contracted the herpes whitlow. I have never had any type of skin problem on my genitals and I check myself very closely. Should I worry about having breakouts on my genitals or transferring to my girlfriend ? Also, is it possible to be infected with the HSV 2 virus if I've already had this herpetic whitlow ?
Submitted: 4 months ago.
Category: Dermatology
Expert:  DIEGO BONILLA replied 4 months ago.

Hello

This is Dr. Bonilla, experienced in Internal Medicine, Pulmonary and Critical Care.

I understand your concerns. HSV check for IgM and IgG titer. Usually a positive test means that you were exposed to the disease years ago. With no symptoms an acute infection is unlikely. If you are positive it means that you could potentially have a breakout at any point in the future. However breakouts only happen if you are immunosupress. You are only contagious when you have the rash and active oozing. Let me know if you have any other questions.

Thanks

Customer: replied 4 months ago.
Thank you. My question is actually more directed to Herpetic Whitlow, where I do have active breakouts on my thumb. What I am curious about is that if I am already infected with HSV 2 manifested as Herpetic Whitlow, will this also mean I could have a break out on my genitals at some point or will it remain on my thumb where the initial infection began ?
Expert:  DIEGO BONILLA replied 4 months ago.

You have the virus in your body so it can cause a breakout anywhere. Usually with HSV2 the genital area is affected. Please rate my answer.

Thanks

Customer: replied 4 months ago.
Ok. I will have to find a specialist who has experience with herpetic whitlow. Thanks.
Expert:  DIEGO BONILLA replied 4 months ago.

Your PCP or infectious diseases doctor can help you with an acute episode. Please rate my answer

Expert:  Dr. Nair replied 4 months ago.

Hello,

Thank you for your question. My name is***** and I am a dermatologist. As such we are the specialists which deal with Herpetic Whitlow.

I will have to respectfully ***** ***** my colleague's opinion. Herpetic Whitlow is caused by both HSV 1 and HSV 2 with HSV 2 being responsible for nearly half the cases. Herpes is a localized infection after the initial 2 weeks and is limited to one or a few nerve roots in the affected area - the reactivation and subsequent symptoms only occur in this area. And it is rare for the patient to auto-infect himself in other areas.

So in all likelihood you will never have a genital herpes episode in your life and your positive HSV 2 test is solely because of the Herpetic Whitlow.

Hope this helps.