Whitlow is an infection of the skin and occasionally pulp space of the finger, usually caused by herpes simplex type I virus; in this case, it is called a herpetic whitlow. It is very common amongst medical and dental personnel, and children.
It causes a throbbing pain. The fingertip is reddened, swollen and acutely tender. Vesicles form which then merge to give bullae. The bullae crust over and heal over the course of about a month. It can lead to vessel thrombosis distally with avascular necrosis of the phalanx.
Diagnosis is usually obvious from the history and examination. Serum herpes antibodies may assist.
The lesion should not be drained due to the tendency for bacterial superinfection. If the lesion is painful, topical antivirals are commenced e.g. acyclovir.
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