Ophthalmic Herpes Virus Infection and Hutchinson Sign

If you see herpes vesicles on the nose tip and sides of the nose, be careful: Ophthalmic herpes and Hutchinson Sign

My little daughter appeared on her right eyebrow and on her nose a few days before herpes lesions. When close to the eye, we were alarmed before it could cause corneal involvement and eye damage.

Here are the photos that before the treatment :

Ophthalmic Herpes Virus Infection and Hutchinson Sign

Ophthalmic Herpes Virus Infection and Hutchinson Sign

Ophthalmic Herpes Virus Infection and Hutchinson Sign

Ophthalmic Herpes Virus Infection and Hutchinson Sign

British surgeon, ophthalmologist and pathologist Sir Jonathan Hutchinson (1828-1913), I would like to mention a few signs used in medicine starting with "Hutchinson".

• Hutchinson sign

Two Hutchinson signs have been identified and used in two separate sections

Hutchinson sign (ophthalmology)

Nasociliary nerve -
This sign is seen as a result of the involvement of the nasal branches of the nasociliary nerve (ophthalmic part of the trigeminal nerve), vesicles are seen on the nose (typical herpes lesions) and this nerve involvement can occur with eye involvement. The nasociliary branch of the trigeminal nerve innervates both the cornea, the lateral dorsum of the nose and the tip of the nose. In other words, the presence of herpes vesicles on the sides of the tip of the nose and the back of the nose is called the Hutchinson sign. As seen in the figure, herpes spread through the nerve can spread to the nose and eye region where this nerve extends.

Hutchinson sign (dermatology)

Refers to pigmentation in the paronychial area, suggesting subungual melanoma.

• Hutchinson triad

Congenital syphilis consists of the Hutchinson trio:

1. dental abnormalities
2. interstitial keratosis
3. deafness

• Hutchinson's pupil

Hutchinson pupil shows a fixed and enlarged pupil due to compression of the oculomotor nerve (CN III) as a result of uncal herniation.

• Hutchinson freckle (Hutchinson's melanotic freckle)

Also known as lentigo maligna, it occurs in 5-15% of cases of malignant melanoma.

• Hutchinson teeth

Hutchinson teeth are smaller and wider than normal and have a notch structure on their bite surfaces.

• Hutchinson syndrome

Hutchinson's syndrome is defined as a defective and irritable condition for skeletal metastases in neuroblastoma.

Oral and locally effective antiviral drugs are used in the treatment. However, it may be helpful to consult an ophthalmologist. In this case, you have to be very careful:

The appearance of rash in the supratrochlear nerve distribution is a precursor of clinical involvement of the eye. Especially the presence of redness in the eyes can be a harbinger of disease severity. Outside the nose, pain, photophobia, or visual impairment can occur in severe cases. So if your child has a red eye with herpes lesions on her nose or if herpes lesions are added to the upper outer and middle of the eyebrow, consult a skin, ENT or ophthalmologist.

supratrochlear nerve -
The supratrochlear nerve is an end branch of the frontal nerve from the ophthalmic branch of the trigeminal (or fifth) cranial nerve. This is a photograph showing where the supratrochlear nerve branches. The area of ​​my daughter's eyebrow with red and vesicular lesions on the supratrochlear nerve and the region of the supraorbital nerve fits. There are branches of both nerves extending to the forehead and forehead.

Photos of the 4th day after treatment:

Ophthalmic Herpes Virus Infection and Hutchinson Sign

Ophthalmic Herpes Virus Infection and Hutchinson Sign

Ophthalmic Herpes Virus Infection and Hutchinson Sign

Thank goodness the lesions regressed. There are many scientific studies that may cause serious problems with herpes eye involvement. "Ocular herpes simplex virus: how are latency, reactivation, recurrent disease and therapy interrelated?" There is a lot of information in this article. Herpes keratitis, infectious epithelial keratitis, neurotrophic keratopathy, stromal keratitis, endothelial divided into 4 'but the subject, you can consult the eye doctors. Latest guide to the treatment of herpes keratitisitis >> "Herpes Simplex Virus Keratitis: A Treatment Guideline - 2014" Some eye infections are recurrent and can cause serious tissue damage.

Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul

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