ABSTRACT:

Hand-foot-mouth disease is a viral disease that occurs mostly in children, but sometimes affects adults as well. It is most often caused by Coxsackie virus A16 or Enterovirus 71. Other strains of these viruses can also be an etiological factor for the development of the disease. It usually starts with an increase in body temperature and fatigue. Subsequently, papulo-vesicular rashes appear on the oral mucosa, palms and soles. Over time, some of them form small erosions or ulcers. Although rare, few weeks after an infection has passed, nail changes can be seen. Some are associated with falling off the nail plate, others with onychomаdеsis or the development of a bacterial and/or fungal infection. In this report, we present a clinical case of a 22-year-old woman who in the month of September 2022 had hand-foot-mouth disease and two months later developed nail changes associated with a change in the integrity and color of the nail plate.

KEYWORDS:

Hand-food mouth disease, coxsackievirus A16, enterovirus 71, onychomadesis, S. aureus.

REFERENCES :

1) Repass GL, Palmer WC, Stancampiano FF (September 2014). “Hand, foot, and mouth disease: Identifying and managing an acute viral syndrome”. Cleve Clin J Med. 81 (9): 537–43. doi:10.3949/ccjm.81a.13132. PMID 25183845.
2) Li, Y; Zhu, R; Qian, Y; Deng, J (2012). “The characteristics of blood glucose and WBC counts in peripheral blood of cases of hand foot and mouth disease in China: a systematic review”. PLOS ONE. 7 (1): e29003.
Bibcode:2012PLoSO…729003L. doi:10.1371/journal.pone.0029003. PMC 3250408. PMID 22235257.
3) “Causes & Transmission”. CDC. August 18, 2015. Archived from the original on May 14, 2016. Retrieved May 15, 2016.
4) “Hand, Foot and Mouth Disease: Signs & Symptoms”. mayoclinic.com. The Mayo Clinic. Archived from the original on May 1, 2008. Retrieved May 5, 2008.
5) Hoy, NY; Leung, AK; Metelitsa, AI; Adams, S (2012). “New concepts in median nail dystrophy, onychomycosis, and hand, foot and mouth disease nail pathology”. ISRN Dermatology. 2012 (680163): 680163. doi:10.5402/2012/680163. PMC 3302018. PMID 22462009.
6) Wang, Jing (August 21, 2017). “Epidemiological characteristics of hand, foot, and mouth disease in Shandong, China, 2009–2016”. Scientific Reports. 7 (8900): 8900. Bibcode:2017NatSR…7.8900W. doi:10.1038/s41598-017-09196-z. PMC 5567189. PMID 28827733.
7) Haneke E. Onychomadesis and hand, foot and mouth disease—is there a connection? Euro Surveill. 2010;15:2
8) Yotsova R, Dochev D et al. Atypical doesn’t Mean Impossible. Hand-Footh-Mouth Disease.Varna Medical Forum, v. 5, 2016, suppl. 1
9) Di Prinzio A, Bastard DP, Torre AC, Mazzuoccolo LD. Hand, foot, and mouth disease in adults caused by coxsackievirus B1-B6. An Bras Dermatol. 2022;97:321–325.
10) Ramirez-Fort MK, Downing C, Doan HQ, Benoist F, Oberste MS, Khan F, Tyring SK. Coxsackievirus A6 associated hand, foot and mouth disease in adults: clinical presentation and review of the literature. J Clin Virol. 2014;60:381–386.
11) Flipo R, Isnard C, Coutard A, Martres P, Dumas M, Blum L, Begon E. Atypical hand, foot and mouth disease in adults: a note on 6 cases. Ann Dermatol Venereol. 2020;147:857–861
12) Wei SH, Huang YP, Liu MC, et al. An outbreak of coxsackie A6 hand, foot, and mouth disease associated with onychomadesis in Taiwan, 2010. BMC Infect Dis. 2011;11:346–351.
13) Shin JY, Cho BK, Park HJ. A Clinical Study of Nail Changes Occurring Secondary to Hand-Foot-Mouth Disease: Onychomadesis and Beau’s Lines. Ann Dermatol. 2014;26:280–283
14) Paller AS, Mancini AJ Hurwitz Clinical Pediatric Dermatology. A Textbook of Skin Disorders of Childhood and Adolescence. 1993.2nd ed Elsevier:507–508
15) Piraccini BM, Iorizzo M, Starace M, et al. Drug-induced nail diseases. Dermatol Clin. 2006;24:387–391
16) Ciastko AR. Onychomadesis and Kawasaki disease. CMAJ. 2002;166:1069
17) Exuberant hand-foot-mouth disease: an immunocompetent adult with atypical findings. Cordeiro E Cunha J, Lima Silva A, Maia Nogueira R, Silva Fernandes D, Salazar T, Vilela M, Salomão J. Eur J Case Rep Intern Med. 2020;7:1609