Diagnosis: Herpes Simplex (herpetic whitlow)
Painful, grouped vesicles on an eryhematous edematous base on side of the finger.
Painful, grouped vesicles on an eryhematous edematous base on side of the finger.
Submitted by Alaa Saad. Originally posted October 10, 2010.
See case discussion.
• Herpes zoster • Aphthous stomatitis • Impetigo • Contact dermatitis • Erythema multiforme • Herpangina (coxsackievirus) • Syphilitic chancre
• HSV-1 classically orolabial; HSV-2 classically genital — but either can occur at both sites • Tzanck smear: multinucleated giant cells (also positive in VZV — cannot distinguish) • PCR is the gold standard for diagnosis (most sensitive and specific) • Eczema herpeticum: widespread HSV in atopic dermatitis — medical emergency • Herpetic whitlow: HSV infection of the digit — can be confused with bacterial paronychia • Viral shedding can occur asymptomatically — important for counseling • Erythema multiforme is the most common complication of recurrent HSV
Tags: herpes, simplex, herpetic, whitlow, alaa saad