Blistering distal dactylitis

Synonym(s)

Blistering dactylitis

98 Bloch-Siemens syndrome

Definition

Superficial infection of the anterior fat pad of distal phalanx, usually caused by P-hemolytic streptococcal pathogens

Pathogenesis

S. pyogenes colonizes normal skin surfaces for extended periods; following acquisition on the normal skin, minor trauma may be a prerequisite for initiating infection

Clinical manifestation

Tender vesicle or bulla on an erythematous base, covering the volar surface of the affected digit

Differential diagnosis

Herpetic whitlow; friction blister; epider-molysis bullosa; burn trauma

Therapy

Penicillin G benzathine; penicillin VK; incision and drainage

References

Ney AC, English JC 3rd, Greer KE (2002) Coexistent infections on a child's distal phalanx: blistering dactylitis and herpetic whitlow. Cutis 69(I):46-48

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