Atypical presentation of herpetic whitlow as dark brown vesicles in a hyperbilirubinemic patient

Abstract

A 36-year old Caucasian female with a history of metastatic carcinoma of the ovary was hospitalized for a CTguided percutaneous biliary drain placement due to compression of the bile duct by metastases causing severe hyperbilirubinemia. Upon admission the patient mentioned lesions in the left index finger that appeared 12–14 days prior to admission as small tingling reddish vesicles which subsequently grew and darkened. Physical examination was significant for severe jaundice and dark brown vesicular lesions in the left index finger without lymphangitis or lymphadenitis (Fig. 1).