ContentsSynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyReferencesInformation for PatientsView all Images (18)
Herpetic whitlow - Cellulitis DDx
See also in: Overview,Nail and Distal Digit
Print Captions OFF
Other Resources UpToDate PubMed

Herpetic whitlow - Cellulitis DDx

See also in: Overview,Nail and Distal Digit
Print Patient Handout Images (18)
Contributors: Susan Burgin MD, Tara Mahar MD, Art Papier MD
Other Resources UpToDate PubMed

Synopsis

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.

Distinguish herpetic whitlow from cellulitis based on location and the presence of umbilicated vesicles. Patients may have a history of HSV infection elsewhere on the body.

Codes

ICD10CM:
B00.89 – Other herpesviral infection

SNOMEDCT:
43891009 – Herpetic whitlow

Look For

Subscription Required

Diagnostic Pearls

Subscription Required

Differential Diagnosis & Pitfalls

Best Tests

Subscription Required

Management Pearls

Subscription Required

Therapy

Subscription Required

References

Subscription Required

Last Reviewed: 01/30/2017
Last Updated: 03/17/2017
Copyright © 2019 VisualDx®. All rights reserved.
Herpetic whitlow - Cellulitis DDx
See also in: Overview,Nail and Distal Digit
Captions OFF Print 18 Images Filter Images
View all Images (18)
(with subscription)
 Reset
Herpetic whitlow : Axillary lymphadenopathy, Hand edema, Painful skin lesions, Periungual fingers, Vesicles
Clinical image of Herpetic whitlow
A cluster of cloudy vesicles and some small crusts on a brightly erythematous base on the finger.
Copyright © 2019 VisualDx®. All rights reserved.