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Herpetic Whitlow

By

David R. Steinberg

, MD, Perelman School of Medicine at the University of Pennsylvania

Last full review/revision May 2020| Content last modified May 2020
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Topic Resources

Herpetic whitlow is a viral infection of the fingertip.

Herpes simplex virus Herpes Simplex Virus (HSV) Infections Herpes simplex virus infection causes recurring episodes of small, painful, fluid-filled blisters on the skin, mouth, lips (cold sores), eyes, or genitals. This very contagious viral infection... read more Herpes Simplex Virus (HSV) Infections (similar to the one that causes fever blisters) may cause an intense, painful skin infection. The virus enters through a break in the skin. The fingertip is sore and swollen but is not as firm as in a bacterial infection of the fingertip (felon Felon A felon is an infection of the soft tissue (pulp) of the fingertip, usually caused by bacteria. A felon can lead to a pocket of pus (abscess) inside the fingertip, which creates pressure on... read more Felon ). Tiny fluid-filled blisters (vesicles) appear on the fingers but sometimes only 2 or 3 days after pain begins.

Doctors base the diagnosis of herpetic whitlow on the presence of blisters and lack of firmness. A herpetic whitlow may be mistaken for a felon or other viral infection of the hand.

Treatment of Herpetic Whitlow

  • Antiviral drugs

The disorder eventually goes away without treatment but may return. Antiviral drugs applied directly to the skin (topically) can help shorten the length of the first episode. Drugs taken by mouth (such as acyclovir) on a long-term basis may prevent further episodes in people who have already had repeated episodes. People should cover open or draining blisters to prevent spreading the infection to other people. Surgery is not needed.

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Test your knowledge

Reactive Arthritis
Reactive arthritis causes inflammation of the joints and the tendon attachments at the joints. It is called “reactive” because it frequently occurs in reaction to an infection. In which of the following organs is such an infection most likely to occur? 
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