Blistering distal dactylitis: causes, symptoms, diagnosis, and treatment

Blistering distal dactylitis is superficial tender blisters limited to the distal ventral fat pad of digits and is caused by group A β hemolytic streptococcus.


The pathogen is group A β hemolytic streptococcus, sometimes accompanied by staphylococcus aureus, and β hemolytic streptococcus can also be found in other areas such as the pharynx, tonsil, nasal cavity, and skin around the nostrils.

Signs and Symptoms

Blistering distal dactylitis occurs mainly in children aged between 2 and 16 years, but also in adults. It is characterized by single or multiple superficial blisters on the surfaces of proximal, middle, and distal phalanx, with flushing base, with pain when palpation, without systemic symptoms, sometimes with blisters in the nail groove. Numerous neutrophils and Gram-positive cocci can be observed in the blister smears, and group A β hemolytic streptococcus can be cultured.


According to the clinical manifestations and results of bacterial culture, diagnosis can be provided.


Oral antibiotics and local wet compress can be applied, incision and drainage is necessary if with abscess.