clinical features and diagnosis

Last reviewed 01/2018

clinical features and diagnosis

Patients may present with a prodrome of pain, burning sensation, pruritus, and/or tingling sensation of the affected finger or the entire limb (1,2)

  • pain is usually out of proportion to physical findings (3)
  • this is followed by vesicular eruptions with surrounding erythema and oedema (2)
    • the fingertip is reddened, swollen and acutely tender
    • several vesicles (1-3 mm) form on a base of erythema about 7-10 days after the initial symptoms (4), fluid in these vesicles may be clear initially (3)
    • these may then merge to give bullae like lesions, the fluid may become cloudy or bloody (3,4)
    • the pain and swelling decreases and the vesicles crust over and heal after 10-14 days
  • fever, lymphadenitis, and epitrochlear and axillary lymphadenopathy may be seen (3)

Diagnosis is usually obvious from the history and examination. Serum herpes antibodies may assist.

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