Coexistent infections on a child's distal phalanx: blistering dactylitis and herpetic whitlow.

We report a case of coexistent Staphylococcus aureus and herpes simplex virus (HSV) infections responsible for a bullous and vesicular eruption on a child's distal phalanx. Blistering distal dactylitis (BDD), a superficial infection of the distal portion of the finger, is seen most commonly in children and is caused by either beta-hemolytic streptococci or S aureus. Herpetic whitlow, also a blistering infection found on children's distal fingers, is a bacteriologic sterile infection caused by HSV-1 or HSV-2. In this report, we note that these infections may coexist on the distal phalanx. This case has implications for diagnosis and treatment of children's blistering hand diseases.