Herpes simplex virus infection of the hand

History and clinical findings: An 18-month-old infant was admitted for a suspected bacterial hand infection that had developed within 2 days. Examination demonstrated multiple vesicles with erythema involving the dorsoulnar aspect of the thumb. The infant was in a good condition, had no constitutional symptoms and a history of gingivo-stomatitis 6 months ago. Examinations: The diagnosis of herpes simplex infection was based on the history and the clinical findings. Treatment and course: Treatment consisted of dry dressings, and over the next 3 weeks, the lesion healed without scarring. Conclusion: Herpes simplex virus infection of the hand is uncommon, often misdiagnosed and therefore overtreated or inadaequately treated. Usually the diagnosis can be made from history and clinical findings. In general, the infection is managed conservatively. Treatment by incision and drainage is contraindicated.