Figure 538

Subungual recurrent herpes simplex.

Herpes zoster infections, which may affect the proximal nail fold like herpes simplex, also involve the entire sensory dermatome. The pustules of primary cutaneous Neisseria gonorrhoeae infection may resemble herpes simplex on the rare occasion when it occurs on the finger. The diagnosis is established by positive Gram staining and bacteriological culture.

Treatment

Treatment is aimed primarily at symptomatic relief and the avoidance of secondary infection. Topical acyclovir may shorten the course of any one attack; given orally the drug may prevent recurrences while it is being taken. On cessation of the treatment relapses are unfortunately common. This is a preventable infection. Gloves should always be worn on both hands for procedures such as intubation, removal of dentures or providing oral care, despite the additional costs involved.

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