317.A 32-year-old dental hygienist presents to the ED with a painful
lesion at the distal aspect of her right index finger. The individual states
that she had a low-grade fever and malaise over the last week and subse-
quently developed pain and burning of the infected digit. Within the next
week, she noted erythema, edema, and the development of small grouped
vesicles on an erythematous base as depicted in the image below. Which of
the following should be avoidedwhen managing this condition?
330 Emergency Medicine
a. Performing an incision and drainage to facilitate healing and avoid bacterial
superinfection.
b. Splinting the finger and recommending elevation and analgesics.
c. Prescribing an antiviral agent, such as acyclovir.
d. Applying a dry dressing over the lesions to prevent transmission.
e. Prescribing an antibiotic if there is evidence of bacterial superinfection.
(Reproduced, with permission, from Wolff K, Johnson RA, Suurmond R.Fitzpatrick’s Color Atlas
& Synopsis of Clinical Dermatology. 5th ed. New York, NY: McGraw-Hill; 2005: Figure 25-27.)