Hand and finger infections

Background

Wrist and hand deeper palmar dissection

Distal interphalangeal dislocation (DIP), proximal interphalangeal dislocation (PIP), and metacarpophalangeal dislocation (MCP) joints of the finger shown.

Volar/anterior finger anatomy.

Lateral finger anatomy.

• Patients with systemic symptoms due to a hand infection are seriously ill and require inpatient management

Hand Anatomy

• Volar = anterior = dorsal
• Dorsal = posterior = palmar

Nailtip Anatomy

A. Nail plate; B. lunula; C. root; D. sinus; E. matrix; F. nail bed; G. hyponychium; H. free margin.

• The perinychium includes the nail, the nailbed, and the surrounding tissue.
• The paronychia is the lateral nail folds
• The hyponychium is the palmar surface skin distal to the nail.
• The lunula is that white semi-moon shaped proximal portion of the nail.
• The sterile matrix is deep to the nail, adheres to it and is distal to the lunule.
• The germinal portion is proximal to the matrix and is responsible for nail growth.

Clinical Features

Hand and Finger Infections Images

• 

  Bed bugs

• 

  Digital mixoid cyst

• 

  Felon

• 

  Hand cellulitis (from cat bite)

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  Hand-foot-and-mouth disease

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  Herpetic whitlow

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  Paronychia

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  Scabies

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  Lymphocutaneous sporotrichosis

Differential Diagnosis

Hand and finger infections

• Bed bugs
• Closed fist infection (Fight Bite)
• Hand cellulitis
• Hand deep space infection
• Hand-foot-and-mouth disease
• Herpetic whitlow
• Felon
• Flexor tenosynovitis
• Paronychia
• Scabies
• Sporotrichosis

Look-Alikes

• Digital mixoid cyst

Evaluation

• See hand exam

Management

• Depends on specific diagnosis

Disposition

• Depends on specific diagnosis

See Also

• Hand and Finger Diagnoses