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Herpetic whitlow - Nail and Distal Digit
See also in: Overview,Cellulitis DDx
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Herpetic whitlow - Nail and Distal Digit

See also in: Overview,Cellulitis DDx
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Contributors: Susan Burgin MD, Bertrand Richert MD, Robert Baran MD
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Synopsis

Herpetic whitlow : Axillary lymphadenopathy, Hand edema, Painful skin lesions, Periungual fingers, Vesicles
Herpetic whitlow, or distal digital herpes simplex virus (HSV), is an uncommon infection occurring on the fingers or periungually, either from HSV1 or HSV2. Herpetic whitlow from HSV1 usually affects children and dental and medical personnel who do not regularly wear gloves. Toe involvement has been reported in infants from toe sucking. Digital-to-genital contact of HSV2 is also a mode of transmission.

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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Last Reviewed:01/29/2017
Last Updated:11/12/2019
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Herpetic whitlow - Nail and Distal Digit
See also in: Overview,Cellulitis DDx
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A medical illustration showing key findings of Herpetic whitlow : Axillary lymphadenopathy, Hand edema, Painful skin lesions, Periungual fingers, Vesicles
Clinical image of Herpetic whitlow - imageId=133823. Click to open in gallery. caption: 'A cluster of cloudy vesicles and some small crusts on a brightly erythematous base on the finger.'
A cluster of cloudy vesicles and some small crusts on a brightly erythematous base on the finger.

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