The treatment of herpetic whitlow--a new surgical concept.

Characteristics of cutaneous lesions caused by herpes simplex virus (HSV-1) are: Acquired by skin-to-skin contact; humans are the only natural host. Often on the hands of health care personnel. Painful swelling, erythema, vesicles, and ulcerations. Possible involvement of cutaneous digital areas of paronychium, eponychium, and subungual matrix. Similar to a bacterial (septic) or fungal felon. Self-limiting--14- to 21-day course. An aseptic felon, which provides a contraindication to surgical incision and drainage of the deep pulp space. Severe pain: the major complaint from all patients. Relieved of pain by decompression of the involved nail bed, either by segmentally excising or perforating the overlying nail or both to unroof the vesicles.