Herpetic whitlow is a cutaneous infection of the distal aspect of the finger caused by herpes simplex virus.
(See also Overview and Evaluation of Hand Disorders.)
Herpetic whitlow may cause intense pain, redness, and swelling of the finger. The digital pulp is not very tense, but can be erythematous and swollen; fever and lymphadenopathy are also possible. Vesicles develop on the volar or dorsal distal phalanx but often not until 2 to 3 days after pain begins. The intense pain can simulate a felon, but herpetic whitlow can usually be differentiated by the absence of tenseness in the pulp or the presence of vesicles. Herpetic whitlow can also mimic paronychia or other viral infections in the hand (eg, coxsackievirus). The condition is self-limited but may recur.
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