UMEM Educational Pearls


30 year old female presents with a painful finger for 1 week. Finger exam showed the following. What is the diagnosis ?


Herpetic whitlow

- It is caused by either HSV 1 or 2.

- Infection is usually transmitted by direct unprotected contact.

- Healthcare workers are at risk of contracting the infection if appropriate preventative measures were not taken when dealing with patients who have the infection.

- Diagnosis is mainly clinical. Tzank smears can be done to confirm the diagnosis if in doubt.

- Treatment with Acyclovir is thought to shorten the duration of the infection and prevent recurrence if started within 72 hours of beginning of symptoms.

- Incision of the vesicular lesion is contraindicated and can cause severe bacterial superinfection.


McDonald, Lucas S., et al. "Hand infections." The Journal of hand surgery36.8 (2011): 1403-1412.