Herpetic whitlow - Nail and Distal Digit
See also in: Overview,Cellulitis DDxAlerts and Notices
Synopsis
After an incubation period of 3-7 days, during which there may be local erythema and edema as well as tenderness, a group of vesicles appears around the perionychium and on the volar digital skin. Vesicles may progress to erosions or may become pustular first and simulate a felon. Lesions may involve the distal-free edge of the nail and extend into the nail bed, which often results in hemorrhage. Swelling of the hand with lymphatic streaking may also occur.
Recurrences of herpetic whitlow may be seen, especially in immunosuppressed individuals.
Codes
ICD10CM:B00.89 – Other herpesviral infection
SNOMEDCT:
43891009 – Herpetic whitlow
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Differential Diagnosis & Pitfalls
- Paronychia
- Felon
- Cellulitis or erysipelas
- Insect bite
- Fixed drug eruption
- Tinea
- Blistering distal dactylitis
- Erysipeloid
- Orf
- Milker's nodule
- "Seal finger" – Etiologic agent likely Mycoplasma spp.
- Mycobacterium marinum
- Cat-scratch disease
- Sporotrichosis
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Last Reviewed: 01/30/2017
Last Updated: 11/13/2019
Last Updated: 11/13/2019
Herpetic whitlow - Nail and Distal Digit
See also in: Overview,Cellulitis DDx
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