Title: Blistering Distal Dactylics (submitted by Nicole Cimino-Fiallos, MD)<br/>Author: Mimi Lu<br/><a href='http://umem.org/profiles/faculty/185/'>[Click to email author]</a><hr/><div style="color: rgb(187, 165, 4); font-size: 20px; font-family: verdana,arial,helvetica,sans-serif;">
<span style="font-size:14px;"><span style="color: rgb(102, 102, 102); font-family: verdana,arial,helvetica,sans-serif;">Who- Mostly seen in children, but sometimes in immunocompromised adults</span></span></div>
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<span style="font-size:14px;"><span style="color: rgb(102, 102, 102); font-family: verdana,arial,helvetica,sans-serif;">What- Peri-ungal infection of the fingerpad with pus-filled blister with erythematous base</span></span></div>
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<span style="font-size:14px;"><span style="color: rgb(102, 102, 102); font-family: verdana,arial,helvetica,sans-serif;">Cause- May result from thumb or finger sucking. Staph and strep are the most common bugs, but it can be caused by MRSA.</span></span></div>
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<span style="font-size:14px;"><span style="color: rgb(102, 102, 102); font-family: verdana,arial,helvetica,sans-serif;">DDx- herpetic whitlow, paronychia/felon, friction blister, insect bite</span></span></div>
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<span style="font-size:14px;"><span style="color: rgb(102, 102, 102); font-family: verdana,arial,helvetica,sans-serif;">Treatment-</span></span></div>
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<span style="font-size:14px;"><span style="color: rgb(102, 102, 102); font-family: verdana,arial,helvetica,sans-serif;">1. De-roof the blister</span></span></div>
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<span style="font-size:14px;"><span style="color: rgb(102, 102, 102); font-family: verdana,arial,helvetica,sans-serif;">2. Send drainage for culture</span></span></div>
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<span style="font-size:14px;"><span style="color: rgb(102, 102, 102); font-family: verdana,arial,helvetica,sans-serif;">3. Treat for staph and strep- no indication to treat for MRSA initially unless strong suspicion</span></span></div>
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<span style="font-size:14px;"><span style="color: rgb(102, 102, 102); font-family: verdana,arial,helvetica,sans-serif;">4. 10 day course of antibiotics recommended</span></span></div>
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<span style="font-size:14px;"><span style="color: rgb(102, 102, 102); font-family: verdana,arial,helvetica,sans-serif;">For additional information and image: http://www.medscape.com/viewarticle/718695_3</span></span></div>
<fieldset><legend>References</legend>
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<font face="arial, helvetica, sans-serif"><span style="color: rgb(102, 102, 102);">1) Fretzayas A1, Moustaki M, Tsagris V, Brozou T, Nicolaidou P. </span>MRSA blistering distal dactylitis and review of reported cases.<span style="color: rgb(102, 102, 102);"> Pediatr Dermatol. 2011 Jul-Aug;28(4):433-5. PMID: </span>21438916<span style="color: rgb(102, 102, 102);">. </span></font></div>
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2) Cohen R, Levy C, Cohen J, Corrard F, Deberdt P, Béchet S, Bonacorsi S, Bidet P. Diagnostic of group A streptococcal blistering <wbr />distal dactylitis. <span class="m_-1402380293880668198gmail-jrnl" style="font-size: 0.923em;" title="Archives de pediatrie : organe officiel de la Societe francaise de pediatrie">Arch Pediatr</span><span style="font-size: 0.923em;">. 2014 Nov;21 </span></p>
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