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Ask Dr. Muneeb Ali Your Own Question
Dr. Muneeb Ali
Dr. Muneeb Ali, Intensivist
Category: Dermatology
Satisfied Customers: 3093
Experience:  MBBS, MD, MCCM.Currently working in Critical Care Medicine with 10 year experience in Medicine
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I have a herpetic Whitley breakout on my index finger. It's

Customer Question

I have a herpetic Whitley breakout on my index finger. It's very swollen won't bend much. Never had this happen. I also have swelling in top of hand and arm burning tingling in arm and arm pit in veins . Iv had blood clot b4 that done this same thing w out the breakout. Would the hw cause this also
JA: How long have you been dealing with the burning? Are you experiencing any other discomfort?
Customer: Literally woke up like this wasn't there last night
JA: Anything else in your medical history you think the doctor should know?
Customer: I have psoriatic arth and am on injections for that
Submitted: 1 month ago.
Category: Dermatology
Expert:  Dr. Muneeb Ali replied 1 month ago.

Hi,

Im sorry to hear about your symptoms. Can i ask do you have any redness in the arm or hand? What injections are you on for psoriatic arthritis?

Expert:  Dr. Muneeb Ali replied 1 month ago.

Since you seem to be offline, ill leave a response here which we can discuss later on.

Now from what you are describing it sounds like that the infection has spread to the hand and may be spreading upwards into the arm. The swollen hand and the burning pain can indicate that you are developing cellulitis of the hand which may move on to infect the arm as well. Secondly this sounds like a bacterial infection more than herpetic whitlow. It is possible that you may have had herpecti whitlow to start with however there can now be a superimposed bacterial infection on top of it which is spreading rapidly. Secondly it is possible that since you are on injections for the psoriatic arthritis (which i assume are biologic agents like cimzia etc) your immunity could have been compromised and you can get bacterial infections much more easily.

Given the situation i would STRONGLY suggest that you have this evaluated as soon as possible, i think you need immediate antibiotic therapy to control the infection and you should also get a doppler ultrasound done as well. This would help rule out a blood clot as well, it is more likely that you have superficial blood clots in the small veins which can cause the burning pain. This can occur in severe infections and in such a situation usually antibiotics are more than enough to treat the problem.

But this does require immediate medical intervention and i would not advise that you treat this at home especially since the hand is swollen as well.

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