Herpetic whitlow.

Herpetic whitlow is a painful cutaneous infection that most commonly affects the distal phalanx of the fingers and occasionally the toes. It is caused by herpes simplex virus (HSV) types 1 or 2. Herpetic whitlow has been known mainly for infecting healthcare workers in contact with infected secretions or mucous membranes, but the implementation of universal precautions has resulted in a decrease in the incidence of occupation-related cases. Herpetic whitlow occurs mainly in adults aged 20 to 30 years and children. In children, most cases can be attributed to autoinoculation of HSV-1, while in adolescents and adults, herpetic whitlow tends to be caused by autoinoculation of HSV-2. Herpetic whitlow may have a prodrome of burning, pruritus, and/or tingling of the affected finger or the entire limb, followed by erythema, pain, and vesicle formation.