Herpetic whitlow on a finger is treated with which therapy?

• A. Topical or oral antiviral
• B. Broad-spectrum antibiotics
• C. Incision and drainage
• D. Antifungal cream

Answer: (A)

Herpetic whitlow is caused by herpes simplex virus, so the treatment goal is to suppress viral replication with antiviral therapy. Antiviral medications such as topical or oral acyclovir (or other nucleoside analogs like valacyclovir) help shorten the duration of symptoms, reduce pain, and speed healing. Antibiotics won’t help because the lesion is viral, and incision and drainage isn’t appropriate for a vesicular HSV infection and can increase risk of spread or bacterial superinfection. Antifungal creams target fungi and are not effective against a viral infection. Early antiviral therapy is most beneficial, with oral therapy used for most infections and topical options for localized lesions.