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What Is Hutchinson's Sign?

Hutchinson's Sign is a critical indicator in dermatology, often associated with herpes zoster, which affects the eye. It's seen when a rash appears on the tip of the nose, signaling potential eye involvement and risk of complications. Understanding this sign can be vital for timely treatment. How might recognizing Hutchinson's Sign impact your health? Explore the implications with us.
Jennifer Mackin
Jennifer Mackin

The term Hutchinson’s sign is commonly used to refer to two unrelated medical symptoms seen on the face and nails. On the face, it can be used to describe to a skin lesion, from the herpes zoster virus, that forms on the tip of the nose. The name can also be used for discoloration of the nails due to green nail syndrome and melanonychia. Hutchinson’s sign is named after Sir Jonathon Hutchinson, an English doctor who first researched the conditions.

The herpes zoster virus is the medical term for what is more commonly called shingles. It is caused by the chicken pox virus. After an initial outbreak of chicken pox, the virus can lie dormant inside the body for a long time. Sometimes infection or injury can reactivate the virus but, instead of breaking out in a chicken pox rash again, it attaches to a nerve and causes a painful patch of blisters to form on the skin above.

Hutchingson's sign may refer to skin lesions on the face.
Hutchingson's sign may refer to skin lesions on the face.

Shingles on the face can spread to the nasociliary nerve, located in the nasal branch. This nerve is also connected to another that leads to the eye. If the virus causes a skin lesion on the tip of the nose, it can be a Hutchinson’s sign and indicate that the nerve to the eyes has been compromised. The spread of the virus on this part of the body can cause facial paralysis and hearing loss.

Some cases of subungual melanoma may require toe amputation.
Some cases of subungual melanoma may require toe amputation.

Green nail syndrome is caused by bacteria called pseudomonas that can get under the nail and can give the nail a green hue. This is typically a harmless Hutchinson’s sign that does not need medical intervention. People who spend a lot of time with their hands submerged in water have a higher likelihood of contracting the bacteria. Treatment usually involves keeping the nail bed dry and the nails clipped until the discoloration fades with growth and trimming.

AFter the initial outbreak of chicken pox, the herpes zoster virus can stay dormant for a long time.
AFter the initial outbreak of chicken pox, the herpes zoster virus can stay dormant for a long time.

Another condition that can include a Hutchinson’s sign is melanonychia, which typically causes discoloration of the finger or toe nails. This is usually seen as a dark-colored band that runs the length of the nail. Fungal infections, injury to the nail, and inflammatory disorders can cause the discoloration.

A more serious form of melanonychia, called subungual melanoma, can also cause such a darkened band to appear on nails. This is a rare, but serious form of cancer in the nail. Such dark lines should be checked out by a doctor to eliminate the possibility this condition. If the melanoma is suspected, the doctor may perform a biopsy. Most subungual melanoma must be surgically removed and, if necessary, the fingertip or toe may be amputated.

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    • Hutchingson's sign may refer to skin lesions on the face.
      By: librakv
      Hutchingson's sign may refer to skin lesions on the face.
    • Some cases of subungual melanoma may require toe amputation.
      By: memorisz
      Some cases of subungual melanoma may require toe amputation.
    • AFter the initial outbreak of chicken pox, the herpes zoster virus can stay dormant for a long time.
      By: Photozi
      AFter the initial outbreak of chicken pox, the herpes zoster virus can stay dormant for a long time.
    • Herpes zoster is caused by the chicken pox virus.
      By: Gabriel Blaj
      Herpes zoster is caused by the chicken pox virus.